Detection of pneumolabyrinth after temporal bone trauma using computed tomography

Abstract

Only six patients (7% of those with OCD fractures or 1.5% of those with temporal bone fracture) were found to have pneumolabyrinth. Locations of the pneumolabyrinth were in the vestibule in all six cases and three of them showed air densities both in the cochlea and semicircular canal. The size of the air density in the vestibule was 5.38 ± 4.56 mm(2) at the axial view and 6.57 ± 5.67 mm(2) at the coronal view. The mean minimal Hounsfield unit (HU) of air density area in the vestibule was -968.1 ± 22.94 at the axial view and -941 ± 16.88 at the coronal view. Patients with pneumocochlea eventually developed total hearing loss.

Pneumolabyrinth as an Early Computed Tomographic Finding After Cochlear Implantation and its Clinical Significance

“…Previous studies on middle ear trauma or temporal bone fracture suggested that the location of pneumolabyrinth may serve as a prognostic factor for the recovery of inner ear dysfunction (6,21). In patients with middle ear trauma or temporal bone fracture, pneumolabyrinth was usually found in the vestibule adjacent to the oval window, because air entered the inner ear from the middle ear or mastoid cavity.…”

“…The incidence of pneumolabyrinth may vary according to the time interval between insult onset and imaging evaluation. A 10-year cohort study of patients with temporal bone fracture reported that pneumolabyrinth was observed in 1.5% of all temporal bone fractures diagnosed using TBCT regardless of the time at which imaging was performed after the trauma (6). In another study on temporal bone trauma, 8% of patients with temporal bone fracture who visited the emergency room showed pneumolabyrinth on TBCT performed on the day of the visit (19).…”

“…It is diagnosed radiologically when an air signal is seen in the inner ear cavity filled with the soft-tissue signal representing inner ear fluids on temporal bone computed tomography (TBCT) (5). Barotrauma, temporal bone fracture following head trauma, and stapes surgery are well-known causes of pneumolabyrinth (6)(7)(8).…”

Report of an Otic Capsule Disrupting Fracture of the Temporal Bone: Visualization of Pneumolabyrinth and Functional Assessment

“…The presence of air inside the labyrinth also called pneumolabyrinth, is a rare and abnormal finding which can be the result of communication between the middle ear spaces and the inner ear. The most common etiologies are trauma and iatrogenic manipulations around the oval window [4,[6][7][8][9][10]. Traumatic pneumolabyrinth can occur in 7.1-48.4% of OCD fractures but is not present in the cases of OCS fractures, thus it can be an indirect marker of OC damage [7,8].…”

A Rare Cause of Vertigo- Case Report and Review of Literature

“…The incidence of occurrence of pneumolabyrinth is seldom in comparison to other sequelae of temporal bone trauma. In a series by Choi et al the incidence of pneumolabyrinth was 8% among the trauma cases with temporal bone fracture while in another series by Choi et al it was 1.5% [2,3]. The various causes other than temporal bone fracture causing pneumolabyrinth are rupture of round window due to an impulsive force, perilymphatic fistula, displacement of stapes prosthesis into vestibule, congenital malformations, fracture or dislocation or subluxation of stapes and cochleostomy with cochlear implant within [4][5][6][7][8][9][10].…”