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Pneumolabyrinth, intracochlear and vestibular fluid loss after cochlear implantation.

Abstract
The present case was a 38-year-old male who presented with progressive hearing loss, resulting in profound bilateral hearing loss. He had a past history of childhood medulloblastoma, which was treated with posterior fossa craniotomy and radiotherapy. A ventriculoperitoneal (VP) shunt was put in place to manage the hydrocephalus. Cochlear implantation (CI) was carried out on his right ear by a standard procedure. At CI activation, the electric impedance of the electrode was very high, and computed tomography revealed that there was no area of liquid density, suggesting depletion of the perilymph in the cochlea and vestibule. Eight months later, the impedance improved gradually, and the cochlea was filled with perilymph. Consequently, one of the causes of the pneumolabyrinth in the present case was that a scarred stenotic cochlear canaliculus secondary to surgery or radiation therapy might have prevented the CSF from filling the scala. In addition, it is also possible that the VP shunt might have altered the CSF pressure, leading to depletion of the perilymph.
AuthorsHideaki Moteki, Yasunari Fujinaga, Tetsuya Goto, Shin-Ichi Usami
JournalAuris, nasus, larynx (Auris Nasus Larynx) Vol. 45 Issue 5 Pg. 1116-1120 (Oct 2018) ISSN: 1879-1476 [Electronic] Netherlands
PMID29680680 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2018 Elsevier B.V. All rights reserved.
Topics
  • Adult
  • Cerebellar Neoplasms (complications, therapy)
  • Cochlear Implantation
  • Constriction, Pathologic (complications)
  • Craniotomy
  • Electric Impedance
  • Hearing Loss, Bilateral (complications, rehabilitation)
  • Humans
  • Hydrocephalus (etiology, surgery)
  • Labyrinth Diseases (etiology, physiopathology)
  • Labyrinthine Fluids
  • Male
  • Medulloblastoma (complications, therapy)
  • Neurosurgical Procedures
  • Perilymph
  • Postoperative Complications (etiology, physiopathology)
  • Radiotherapy
  • Tomography, X-Ray Computed
  • Ventriculoperitoneal Shunt
  • Vestibule, Labyrinth

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