Pneumolabyrinth as an Early Computed Tomographic Finding After Cochlear Implantation and its Clinical Significance

Abstract

Objective: To determine the incidence and volume of pneumolabyrinth using early temporal bone computed tomography (TBCT) findings and evaluate the correlation between pneumolabyrinth and various clinical variables. Study Design: Retrospective case review. Setting: Tertiary academic center. Patients: Fifty-three consecutive adult cochlear implantation (CI) recipients (53 ears) with normal inner ears who underwent high-resolution TBCT within 3 days after CI were included. Intervention: Axial TBCT images were used for detection and measurement of pneumolabyrinth. Main Outcome Measures: Incidence and volume of pneumolabyrinth were evaluated. In addition, the following clinical variables were analyzed to evaluate the correlation with pneumolabyrinth volume: demographics, implant type, surgical approach, postoperative dizziness, and preservation of functional residual hearing. Results: Pneumolabyrinth was present in all patients, and the average volume was 8.496 mm3. Pneumolabyrinth was confined to the cochlea (pneumocochlea) in all patients except for one who also had pneumovestibule. The pneumolabyrinth volume in patients with postoperative dizziness was significantly larger than that in patients without postoperative dizziness (10.435 mm3 vs. 8.016 mm3; p = 0.029). Multivariate analysis showed that a larger volume of pneumolabyrinth was significantly associated with postoperative dizziness (odds ratio, 1.420; 95% confidence interval, 1.114–1.808; p = 0.005). Conclusion: A certain volume of pneumolabyrinth was always present in the early stage after CI, and the volume of pneumolabyrinth measured using early TBCT findings was significantly associated with the occurrence of postoperative dizziness.

Postoperative Pneumolabyrinth Following the Middle Cranial Fossa Approach for Superior Semicircular Canal Dehiscence Repair, 2014‐2020

“…Our analysis suggests that patients with pneumolabyrinth were significantly more likely to report dizziness after the MCF than patients without, even after controlling for demographic and important clinical factors. Similarly, a recent study found that pneumolabyrinth after cochlear implantation was significantly associated with dizziness 21 . Two hypotheses were proposed to explain this link: first, pneumolabyrinth can cause disturbances to perilymphatic homeostasis, and thus elicit dizziness; second, pneumolabyrinth can increase the weight of cupula and result in its higher sensitivity to head movements 21 .…”

“…Similarly, a recent study found that pneumolabyrinth after cochlear implantation was significantly associated with dizziness 21 . Two hypotheses were proposed to explain this link: first, pneumolabyrinth can cause disturbances to perilymphatic homeostasis, and thus elicit dizziness; second, pneumolabyrinth can increase the weight of cupula and result in its higher sensitivity to head movements 21 . While these speculations are compelling, additional investigations are warranted.…”

“…21 Two hypotheses were proposed to explain this link: first, pneumolabyrinth can cause disturbances to perilymphatic homeostasis, and thus elicit dizziness; second, pneumolabyrinth can increase the weight of cupula and result in its higher sensitivity to head movements. 21 While these speculations are compelling, additional investigations are warranted. Nevertheless, our finding supports that post-MCF dizziness can be highly suggestive of pneumolabyrinth, and should therefore be closely monitored.…”

Acute pneumolabyrinth: a rare complication after cochlear implantation in a patient with obstructive sleep apnoea on CPAP therapy

“…In a recent study by Im et al , the incidence of pneumolabyrinth was studied in 53 adult patients without inner ear malformations undergone cochlear implantation 18. Patients underwent CT scan 3 days after surgery, and the correlation between the presence of air in the inner ear and some clinical variables was evaluated including type of implant, type of surgical approach, site and volume of the pneumolabyrinth and appearance of symptoms.…”

Emphyseme nach Cochlea-Implantation – Risikofaktoren und Therapieoptionen

“…Die große zeitliche Latenz zwischen dem Auftreten des Emphysems und der Operation scheint pathophysiologisch zunächst ungewöhnlich, da die Wundheilung längst abgeschlossen sein sollte. Eine aktuelle Untersuchung von postoperativen Computertomografien des Felsenbeins, die innerhalb der ersten 3 Tage nach Cochlea-Implantation zur Lagekontrolle der Elektrode durchgeführt worden waren, zeigte in allen untersuchten Fällen ein Pneumolabyrinth [27]. Dieses war jedoch nur in 15,1 % (8 von 53) der Fälle symptomatisch.…”