Assessment of changes in cochlear function with pneumolabyrinth after middle ear trauma

OBJECTIVE: To describe a case of pneumolabyrinth secondary to tympanic membrane/ossicular trauma and the subsequent recovery of sensorineural hearing loss managed with conservative measures. PATIENTS: A 15-year-old boy presented to an outside hospital with signs and symptoms of acute hearing loss, vertigo, and tinnitus after penetrating injury to his right tympanic membrane. In addition, computed tomography demonstrated air density within the vestibule. INTERVENTIONS: The patient was managed conservatively with bed rest, avoidance of straining, corticosteroids, and antibiotics. MAIN OUTCOME MEASURES: Computed tomography, audiologic testing. RESULTS: Patient recovered near-normal hearing subjectively. There was closure of the air-bone gap (≤20 dB) along with resolution of air within vestibule. CONCLUSION: We presented a case of a patient with pneumolabyrinth secondary to penetrating trauma to his tympanic membrane. With supportive treatment, air within the labyrinth resorbed, and the patient recovered sensorineural function. Comparing with the mixed successes of surgical repairs, we propose that initial management for traumatic pneumolabyrinth should be first treated conservatively in the absence of worsening symptoms.