Report of an Otic Capsule Disrupting Fracture of the Temporal Bone: Visualization of Pneumolabyrinth and Functional Assessment

Blunt trauma of the head can result in temporal bone fracture. Different classifications exist, but from a functional perspective, to distinguish otic capsule sparing and otic capsule disrupting fractures is superior to the classic nomenclature. Disruption of the otic capsule is often associated with sensorineural hearing loss, vestibular dysfunction, cerebrospinal leakage, or even intracranial consequences. Pneumolabyrinth describes the condition when air is enclosed within the inner ear. It is a result of a pathological communication between the labyrinth and the middle ear spaces that often occurs due to trauma. It is not a ubiquitous but obvious radiographic hallmark of otic capsule violation. The present case is about a young woman who suffered a temporal bone fracture that involved the right lateral semicircular canal. Multiplanar and segmentation images were generated to depict the pneumolabyrinth developed in the lateral semicircular canal. Despite the preserved hearing, vestibular dysfunction was registered during the video head impulse test and videonystagmography. Treatment of pneumolabyrinth after temporal bone fracture can be a matter of surgery or conservative therapy. In the present case, we preferred conservative therapy because of the absence of serious consequences. Nevertheless, timing and the type of therapeutic modality must be personalized.