Pneumolabyrinth after cochlear implantation in large vestibular aqueduct syndrome: a case report

Pneumolabyrinth as a radiologic sign of a perilymphatic fistula was first reported by Mafee et al [1] shortly after the invention of high-resolution computed tomography (HRCT). The intrusion of air into the inner ear has been described as a complication of petrous bone fractures [2] mostly after direct manipulative trauma to the tympanic membrane, often in combination with a displacement of the stapes into the vestibule [3]. It has also been reported as an iatrogenic complication after stapes surgery, particularly after a stapedectomy [4,5]. We report a case of a radiologically confirmed pneumolabyrinth presumably as a consequence of a strong sneeze in a patient with large vestibular aqueduct syndrome (LVAS). In addition, the patient wears a cochlear implant on the same side. In a theoretical approach, we discuss the probability of the cochleostomy, the LVAS, or an interaction of both being the cause for the pneumolabyrinth.