Pneumolabyrinth: a systematic review.

Area of Science:

• Otolaryngology
• Neurosurgery
• Radiology

Background:

• Pneumolabyrinth (PNL) is a condition characterized by the presence of air within the labyrinthine structures of the inner ear.
• Understanding the causes, presentation, and outcomes of PNL is crucial for effective patient management.

Purpose of the Study:

• To systematically review the literature on the etiology, clinical and radiological presentation, surgical management, and outcomes of pneumolabyrinth (PNL).

Main Methods:

• A systematic literature review was conducted using major electronic databases up to September 2020.
• Studies were selected based on PRISMA standards, focusing on PNL etiology, clinical presentation, treatment, and outcomes.
• A qualitative synthesis of data from 78 included articles involving 132 patients was performed.

Main Results:

• The most frequent causes of PNL were temporal bone fracture (31.8%), stapes surgery (18.2%), penetrating trauma (15.9%), head trauma (14.4%), and barotrauma (11.4%).
• The vestibule was the most commonly affected site (95.3%), followed by the cochlea (40.2%) and semicircular canals (23.4%).
• Vestibular symptoms resolved in most patients, but hearing function prognosis was highly variable.

Conclusions:

• PNL can arise from traumatic, iatrogenic, or inflammatory/infective causes.
• Management options include surgical fistula sealing or conservative treatments.
• Current evidence is insufficient for definitive clinical decision-making due to low certainty.