Unexplained Extensive Skull Base and Atlas Pneumatization

Abstract

Pneumatization of the mastoid and petrous portions of the temporal bones begins late in fetal life, accelerates near and immediately after birth, and continues through infancy, early childhood, and, occasionally, early adult life. This pneumatization can vary greatly, and in cases of well-pneumatized temporal bones, accessory occipital air cells may occur and communicate with the mastoid air cells and middle ear. Other accessory sites of air cell pneumatization include the zygomatic process, squamosal region, and styloid process of the temporal bone.

Extensive craniocervical bone pneumatization

“…To the best of our knowledge, varying combinations of abnormal craniocervical bone pneumatization, with or without trauma, have only been reported in a handful of cases (predominantly in males) (1)(2)(3)(4)(5)(6)(7). A case of an air-filled palpable occipital mass occurring after minor trauma in the presence of extensive pneumatization of the occipital bone was reported as far back as 1940 (1).…”

“…The so-called "proatlas" is derived from the embryonic fourth occipital sclerotome, with its principal derivatives forming the occipital condyles, dorsal articular facets of the atlas, and tip of the odontoid (8). In all cases with reported pneumatization of the atlas, at least one massa lateralis beneath the articular facet was hollow (3,5,7,9). Apart from the presented case, there is only one report of pneumatization of the axis; that case displayed pneumatization of the odontoid tip (6).…”

A Unique Case of Pneumatised Styloid Process with Cholesteatoma

“…Its base becomes embedded in the petromastoid region of the temporal bone thereby making it a part of temporal bone. The pneumatisation of temporal bones starts late in fetal life and continues until the adult life [3]. Pneumatisation process is variable and in cases where there are well pneumatised temporal bones, accessory air cells may occur and communicate with the middle ear mastoid air cells [3, 4].…”

“…The pneumatisation of temporal bones starts late in fetal life and continues until the adult life [3]. Pneumatisation process is variable and in cases where there are well pneumatised temporal bones, accessory air cells may occur and communicate with the middle ear mastoid air cells [3, 4]. Therefore theoretically pneumatisation can be seen in some portions of the skull base as well [3].…”

“…Pneumatisation process is variable and in cases where there are well pneumatised temporal bones, accessory air cells may occur and communicate with the middle ear mastoid air cells [3, 4]. Therefore theoretically pneumatisation can be seen in some portions of the skull base as well [3]. Extensive pneumatisation of skull base and atlas vertebrae [3] has been described in the literature; however, pneumatisation of the styloid process has not been reported before.…”