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An Unusual Pattern of Skull Base Pneumatization.

Ekim Gumeler1, Kader K Oguz1

  • 1Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

The Annals of Otology, Rhinology, and Laryngology
|July 29, 2022
PubMed
Summary

This case study details a rare instance of craniocervical pneumatization leading to spontaneous fracture in a patient experiencing tinnitus. Habitual Valsalva maneuvers were identified as the likely cause of this unusual condition.

Keywords:
aerodynamicspneumocephalusskull basetemporal bone CTtinnitus

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Area of Science:

  • Radiology
  • Neurosurgery
  • Otolaryngology

Background:

  • Craniocervical pneumatization is an uncommon condition.
  • Spontaneous fractures in this region can present with varied symptoms, including tinnitus.
  • The skull base and upper cervical spine are complex anatomical areas where air can abnormally accumulate.

Purpose of the Study:

  • To describe a unique case of craniocervical pneumatization.
  • To highlight the association between this condition and spontaneous fracture.
  • To investigate the etiology of symptomatic pneumatization.

Main Methods:

  • A temporal CT scan was performed on a patient presenting with chronic tinnitus.
  • Detailed patient history was obtained, focusing on potential triggers and prior trauma.
  • Radiological findings were analyzed for evidence of abnormal air collection and bone integrity.

Main Results:

  • CT revealed abnormal pneumatization of the occipital bone and C1 vertebra.
  • A cortical defect was identified, with air present in surrounding soft tissues and the epidural space.
  • Emphysema was most prominent in the suboccipital fossa.

Conclusions:

  • Abnormal pneumatization of the skull base and cervical vertebrae can lead to symptomatic fractures.
  • Habitual Valsalva maneuvers are implicated as the probable cause in this patient.
  • This case underscores the importance of considering pneumatization in the differential diagnosis of unexplained tinnitus and neck pain.