Hearing Loss with Pneumolabyrinth Posttransverse Temporal Bone Fracture

Abstract

Head injury caused by high force can lead to severe complications if fracture of the temporal bone is present. It is rare that temporal bone fracture causes pneumolabyrinth; there is an entry of air into the vestibulocochlear system due to the fracture line communicating inner ear to the middle ear. Vestibular pneumolabyrinth is more common than cochlear pneumolabyrinth. For initial evaluation of polytrauma patients with fracture of the temporal bone, multidetector computed tomography (CT) with high resolution and multiplanar reformation play an important role in the identification of important structures lying in close relation to the temporal bone that may lead to severe complications if fracture line is traversing through them. We herein present an interesting case of a 39-year-old man who underwent a road traffic accident leading to transverse temporal bone fracture and cerebral contusion. After discharge from the hospital, the patient complained of decreased hearing in the ipsilateral ear and difficulty in maintaining balance. On CT, otic capsule violating fracture was noted with pneumolabyrinth. First, the patient was treated conservatively, following no improvement in his condition, he was surgically treated and gained full recovery. Early detection of otic capsule involvement in cases of temporal bone fracture can provide effective treatment which will further lead to decrease in complications which if left untreated could have resulted in drastic consequences contributing to irrecoverable hearing loss. One should always pay attention while reporting for CT scans and always look for the location of air bubbles in the otic capsule as the line of fracture is not visualized properly in the presence of mastoid collection.