Content area
Full Text
We report on a case of pneumolabyrinth in a 60-year-old man after flying induced barotrauma. The patient presented with vertigo and sudden onset hearing loss. CT scan revealed air in the labyrinth. Operative management improved vestibular symptoms but there was no improvement in hearing.
Keywords: pneumolabyrinth, barotrauma
Introduction
Mafee et al coined the term pneumolabyrinth in 1984 to describe air in the labyrinth in a patient with fracture of the stapes footplate1. There have subsequently been 7 cases of pneumolabyrinth reported in the literature,2,3,4 associated with barotrauma5,6, temporal bone fracture3,7, perilymphatic fistula4, fracture of the stapes foot plate1 and complicating stapedectomy8,9. In this article we report a further case of a pneumolabyrinth sustained during flight.
Case Study
Mr. A. a 60-year-old man developed vertigo, nausea, vomiting, ataxia, right sided tinnitus and sudden hearing loss while descending in a commercial aircraft .The symptoms were preceded by popping in his right ear. He had suffered a recent upper respiratory tract infection before flying.
Examination revealed mobile tympanic membranes. Clinically the patient had a profound hearing loss on the right and signs of acute right sided vestibular failure with first degree nystagmus to the left, a positive head impulse test on rotation to the left, and a positive Unterberger stepping test with rotation to the right. There was no evidence of effusion or haemotympanum. Fistula test was negative.
Pure-tone audiometry revealed a profound right sided sensorineural hearing loss and a left high tone sensorineural hearing loss associated with previous noise exposure. (Figure 1). High resolution computerised tomography (CT) of the temporal bones showed air in the right labyrinth (Figure 2).
Exploration of the...