Pneumolabyrinth and Recurrent Paroxysmal Positional Vertigo After Traumatic Stapes Fracture. (April 2019)

• Record Type: Journal Article
• Authors: Comacchio, Francesco; Guidetti, Giorgio; Guidetti, Riccardo; Mion, Marta
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 128:Number 4(2019)
• Page Start: 352
• Page End: 356
• Publication Date: 2019-04
• Subjects: paroxysmal -- perilymphatic fistula -- pneumolabyrinth -- positional -- stapes fracture -- vertigo; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489418819553
• Languages: English
• ISSNs: 0003-4894

Abstract

Objectives: The development of pneumolabyrinth without previous head trauma is a rare event; the associated symptoms may be nonspecific, and they can simulate various cochleo-vestibular pathological entities. The aim of the present study is to describe one of these rare occurrences, characterized by a peculiar onset. Methods: We report a case of stapes fracture secondary to ear pick penetration into the middle ear with a pneumolabyrinth that caused a recurrent paroxysmal positional vertigo (PPV) mimicking a canalolithiasis. Results: The patient developed a profound left sensorineural hearing loss and an intractable PPV with "migrant" features. A pneumolabyrinth was visualized with high-resolution computed tomography. A perilymphatic fistula (PLF) with stapes fracture was found while performing an explorative tympanotomy. After the surgical treatment of the PLF, the patient no longer complained of vestibular symptoms. Conclusions: To our knowledge, this is the fifth case of traumatic pneumolabyrinth simulating a canalolithiasis without previous history of temporal bone trauma and/or middle ear surgery. A pneumolabyrinth should be suspected in case of patients presenting recurrent intractable PPV after ear trauma.