Craniocervical Pneumatization: Estimation of Prevalence and Imaging of Treatment Response. Issue 6 (July 2016)

• Record Type: Journal Article
• Authors: Tomblinson, Courtney M.; Deep, Nicholas L.; Weindling, Steven M.; Lane, John I.; Scheibler, Linsey S.; Barrs, David M.; Hoxworth, Joseph M.
• Is Part Of: Otology & neurotology. Volume 37:Issue 6(2016)
• Page Start: 708
• Page End: 712
• Publication Date: 2016-07
• Subjects: Cervical spine -- Craniocervical pneumatization -- Hyperpneumatization -- Pneumocranium -- Pressure equalization tubes -- Skull base -- Temporal bone; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000001024
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: Estimate the prevalence of craniocervical pneumatization (CCP) and describe successful treatment of this condition with clinical and radiologic correlation. Patients: Individuals with documented CCP on computed tomography (CT). Intervention(s): CT scans of the head, temporal bone, face, neck, and cervical spine. Cessation of habitual Valsalva maneuver (VM) and insertion of pressure-equalization (PE) tubes. Main Outcome Measure: The prevalence of CCP on CT examinations performed during two decades in a large academic healthcare system. Documentation of symptomatic and imaging improvement following treatment of CCP. Results: Radiology database review identified two cases of CCP out of a total of 636, 854 head and neck CT scans (0.00031%) or 43, 553 temporal bone CT scans (0.0046%). Both CCP patients were symptomatic (aural fullness, hearing loss, vertigo) and practiced habitual VM. One patient showed decreased CCP 4 months following cessation of VM, whereas the other patient improved symptomatically and demonstrated reversion of CCP to normal bone on magnetic resonance imaging (MRI) within 3 years following PE tube placement. Conclusions: Acquired CCP is exceedingly rare and, when successfully treated, reversion to normal bone may accompany symptom resolution.