Comacchio Francesco, Guidetti Giorgio, Guidetti Riccardo, Mion Marta
1 Regional Specialized Vertigo Center Veneto Region, Institute of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy.
2 Vertigo Center, Modenese Surgical Clinic, Modena, Italy.
Ann Otol Rhinol Laryngol. 2019 Apr;128(4):352-356. doi: 10.1177/0003489418819553. Epub 2018 Dec 17.
: The development of pneumolabyrinth without previous head trauma is a rare event; the associated symptoms may be nonspecific, and they can simulate various cochleo-vestibular pathological entities. The aim of the present study is to describe one of these rare occurrences, characterized by a peculiar onset.
: We report a case of stapes fracture secondary to ear pick penetration into the middle ear with a pneumolabyrinth that caused a recurrent paroxysmal positional vertigo (PPV) mimicking a canalolithiasis.
: The patient developed a profound left sensorineural hearing loss and an intractable PPV with "migrant" features. A pneumolabyrinth was visualized with high-resolution computed tomography. A perilymphatic fistula (PLF) with stapes fracture was found while performing an explorative tympanotomy. After the surgical treatment of the PLF, the patient no longer complained of vestibular symptoms.
: To our knowledge, this is the fifth case of traumatic pneumolabyrinth simulating a canalolithiasis without previous history of temporal bone trauma and/or middle ear surgery. A pneumolabyrinth should be suspected in case of patients presenting recurrent intractable PPV after ear trauma.
无前驱头部外伤而发生的气迷路极为罕见；相关症状可能不具特异性，可模拟各种耳蜗 - 前庭病理情况。本研究的目的是描述其中一例罕见病例，其具有独特的发病方式。
我们报告一例因挖耳导致中耳穿透继发镫骨骨折和气迷路的病例，该气迷路引发了类似管结石症的复发性阵发性位置性眩晕（PPV）。
患者出现严重的左侧感音神经性听力损失和具有“游走性”特征的顽固性PPV。通过高分辨率计算机断层扫描观察到气迷路。在进行探查性鼓室切开术时发现伴有镫骨骨折的外淋巴瘘（PLF）。PLF经手术治疗后，患者不再诉说前庭症状。
据我们所知，这是第五例模拟管结石症且无前颞骨外伤和/或中耳手术史的创伤性气迷路病例。耳部外伤后出现复发性顽固性PPV患者应怀疑气迷路。
