Bilateral Sequential Pneumolabyrinth Resulting from Nose Blowing

Abstract

Pneumolabyrinth describes a condition with entrapped air in the labyrinth and usually occurs in temporal bone fractures that involve the otic capsule. While sporadic cases of bilateral pneumolabyrinth have been reported, cases lacking head trauma are very rare. We report the case of a 43-year-old man who had sudden hearing loss bilaterally after blowing his nose at an interval of 1 year. Although conservative management for the right ear and exploratory tympanotomy with sealing of the possible site of perilymphatic leakage in the left ear were performed, hearing outcome was poor in both ears. To our knowledge, this is the first case of bilateral pneumolabyrinth occurring as a result of nose blowing.

Keywords: Hearing loss; Perilymphatic fistula; Pneumolabyrinth; Valsalva maneuver.

Fig. 1. CT images of the temporal bones. A: CT scan of the right temporal bone on the day of admission. Air bubbles (arrowheads) are observed in the cochlea and vestibule. B: CT scan of the right temporal bone on the sixth hospital day. Air bubbles (arrowheads) in the cochlea and vestibule are diminished. C: Axial CT scan of the temporal bones on the day of admission. Soft tissue densities (arrowheads) are visible in the both enlarged Eustachian tubes.

Fig. 2. CT images of the temporal bones at second admission. A: CT scan of the left temporal bone. Air bubbles (arrowhead) are visible in the cochlea. B: Soft tissue densities (arrowhead) are seen in the middle ear. C: Axial CT scan of the temporal bones. Enlarged Eustachian tubes are observed (arrowheads).