ASHNR '98'

uhrad.com - Case #8

Clinical History: History withheld.

Post Traumatic Pneumolabyrinth

Findings: A small amount of air is present within the vestibule of the left temporal bone. This is best appreciated in the coronal image at the upper right and in the axial image on the lower right. A linear fracture can be seen crossing the posterior semicircular canal. In addition, there is gas present within the sigmoid sinus.

Discussion: Perilymphatic fistula may develop through either the oval window or round window. The more common occurrence is an oval window fistula due to a fracture which extends through the footplate. Perilymphatic fistulas occur both with transverse and longitudinal fractures. This patient presented with profound vertigo 48 hours following head trauma. There was also profound sensory neuro hearing loss which is due to dampening of the fluid wave secondary to air within the inner ear.

Reference:
Weissman and Curtin. Pneumolabyrinth: A CT Sign of Fracture. Journal of Clinical Radiology. March 1992.

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