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Αλέξανδρος Γ. Σφακιανάκης

Thursday, September 30, 2021

Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

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Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print.

ABSTRACT

Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petr ous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surgically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications.

PMID:34587824 | DOI:10.1177/01455613211048966

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