[Pneumolabyrinth. Radiologic sign of perilymph fistula]

Post-traumatic cochleo-vestibular symptoms can be caused by peri-lymph fistulas, although these cannot be proven preoperatively in most cases by direct clinical examination. A rare case of a traumatic burst fracture of the promotory wall with a consequent perilymph fistula is presented. A preoperative computed tomographic finding of air in the basal turn of the cochlea and superior semicircular canal (pneumolabyrinth) is a reliable sign of perilymph fistula and justifies operative exploration for closure of the fistula. High-resolution computer tomographic imaging of the petrous bones in patients with post-traumatic cochleo-vestibular disturbances is mandatory.