[Fatal outcome after retrograde insufflation of the eustachian tube]

This case report describes a lethal complication of retrograde air insufflation through the Eustachian tube after myringotomy. A 35-year-old woman presented with otalgia and hearing loss in her left ear, which had occurred after an upper respiratory infection. Otoscopy showed a middle ear effusion. A myringotomy was performed under mask anesthesia in a private clinic. During subsequent retrograde Eustachian tube insufflation, the patient experienced sudden convulsions, followed by cardiac and respiratory arrest. The patient then died some hours later from generalized cardiac and circulation break-down in the intensive care unit of a nearby hospital. The cause of the cardiac and circulation collapse could not be defined completely, but it is believed than an anatomical variant of the tegmen tympani was responsible for the tragic outcome because of an air embolus.