Imaging case study of the month: traumatic pneumolabyrinth

Pneumolabyrinth is a condition in which air is present in the vestibule and/or in the cochlea. Air inside the inner ear structures is uncommon, and is not detected even in otic capsule-violating fractures or in transverse fractures of the temporal bone. It is rarely described in the literature. We present a longitudinal computed tomography (CT) study of a significant pneumolabyrinth due to temporal bone trauma in a 31-year-old man. Routine CT of the cranium performed 3 hours after the accident showed air inside the vestibule (pneumolabyrinth). Two days later, a new CT study was performed. The air in the vestibule was partially resorbed. There was opacity over the oval window niche and the promontory. Thirteen months after the initial head trauma, another CT examination showed a fracture line running from the vestibule to the posterior wall of the petrous bone. The patient had profound sensorineural hearing loss after the trauma, and the pneumolabyrinth cleared over a few months. Surgical treatment was not indicated.