Pneumolabyrinth associated with perilymph fistula.

Pneumolabyrinth associated with perilymph fistula, especially with the presence of air in the cochlea, has rarely been identified using imaging study. We present a 24-year-old woman who experienced right fluctuating sensorineural hearing impairment and dis-equilibrium after sustaining an open-handed slap on the right side of her face. The diagnosis of pneumolabyrinth was established through the detection of air bubbles in the right basal turn of cochlea using high-resolution computerized tomography. Right side exploratory tympanotomy confirmed the presence of a perilymph fistula. The patient was free of symptoms after surgery. Early fistula repair was beneficial in this case.