Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;278(12):4619-4632.
doi: 10.1007/s00405-021-06827-0. Epub 2021 Apr 21.

Pneumolabyrinth: a systematic review

Cecilia Botti  1 , Andrea Castellucci  2 , Francesco Maria Crocetta  2 , Martina Fornaciari  2 , Davide Giordano  2 , Chiara Bassi  3 , Angelo Ghidini  2
Affiliations

Pneumolabyrinth: a systematic review

Cecilia Botti et al. Eur Arch Otorhinolaryngol. 2021 Dec.

Abstract

Purpose: The aim of this study is to provide a systematic review of the literature about the etiology, clinical and radiological presentation, surgical management, and outcomes of pneumolabyrinth (PNL).

Methods: A systematic review of the literature was performed including studies published up to September 2020 in electronic databases (PubMed/MEDLINE, EMBASE, Cochrane Library, and Scopus). The PRISMA standard was applied to identify English, Italian, or French-language studies mentioning PNL. Full texts lacking information on the etiology were excluded. Data concerning the cause, site of air bubbles/fistula, clinical presentation, treatment, and outcome were collected. A qualitative synthesis of the results was performed.

Results: Seventy-eight articles were eventually included; 132 patients were involved in the qualitative synthesis. The most common causes were: stapes surgery (24/132, 18.2%), temporal bone fracture (42/132, 31.8%), head trauma without temporal bone fracture (19/132, 14.4%), penetrating trauma (21/132, 15.9%), and barotrauma (15/132, 11.4%). The site most commonly involved was the vestibule (102/107, 95.3%), followed by cochlea (43/107, 40.2%) and semicircular canals (25/107, 23.4%).

Conclusion: The etiopathogenesis of PNL can be summarized in traumatic, iatrogenic, or inflammatory/infective. Its management consists in exploratory tympanotomy and sealing the fistula, but also conservative treatments can be attempted. Vestibular symptoms disappear in the majority of cases. Instead, the prognosis of hearing function is widely variable, and complete recovery is less probable. The certainty of evidence is still too low to make it useful for clinical decision-making.

Keywords: Air; Mastoiditis; Otic capsule; Otogenic meningitis; PLF; Pneumolabyrinth; Temporal bone fracture.

PubMed Disclaimer

References

    1. Mafee MF, Valvassori GE, Kumar A, Yannias DA, Marcus RE (1984) Pneumolabyrinth: a new radiologic sign for fracture of the stapes footplate. Am J Otol 5:374–375 - PubMed
    1. Hidaka H, Miyazaki M, Kawase T, Kobayashi T (2012) Traumatic pneumolabyrinth: air location and hearing outcome. Otol Neurotol 33:123–131. https://doi.org/10.1097/MAO.0b013e318241bc91 - DOI - PubMed
    1. Achache M, Sanjuan Puchol M, Santini L et al (2013) Late pneumolabyrinth after undiagnosed post-traumatic PLF. Case report illustrating the importance of systematic emergency management. Eur Ann Otorhinolaryngol Head Neck Dis 130:283–287. https://doi.org/10.1016/j.anorl.2012.04.012 - DOI - PubMed
    1. Lao WW, Niparko JK (2007) Assessment of changes in cochlear function with pneumolabyrinth after middle ear trauma. Otol Neurotol 28:1013–1017. https://doi.org/10.1097/MAO.0b013e31815a9f2b - DOI - PubMed
    1. Woo HJ, Song SY, Kim YD et al (2008) Pneumolabyrinth without temporal bone fracture: different outcomes for hearing recovery. Laryngoscope 118:1464–1466. https://doi.org/10.1097/MLG.0b013e318172ab03 - DOI - PubMed

Publication types

LinkOut - more resources