Successful conservative treatment of an intracranial pneumatocele with post-traumatic hypoglossal nerve palsy secondary to diffuse temporal bone pneumocele: case report and review of the literature.

Abstract

BACKGROUND:

A pneumocele occurs when an aerated cranial cavity pathologically expands; a pneumatocele occurs when air extends from an aerated cavity into adjacent soft tissues forming a secondary cavity. Both pathologies are extremely rare with relation to the mastoid. This paper describes a case of a mastoid pneumocele that caused hypoglossal nerve palsy and an intracranial pneumatocele.

CASE REPORT:

A 46-year-old man presented, following minor head trauma, with hypoglossal nerve palsy secondary to a fracture through the hypoglossal canal. The fracture occurred as a result of a diffuse temporal bone pneumocele involving bone on both sides of the hypoglossal canal. Further slow expansion of the mastoid pneumocele led to a secondary middle fossa pneumatocele. The patient refused treatment and so has been managed conservatively for more than five years, and he remains well.

CONCLUSION:

While most patients with otogenic pneumatoceles have presented acutely in extremis secondary to tension pneumocephalus, our patient has remained largely asymptomatic. Aetiology, clinical features and management options of temporal bone pneumoceles and otogenic pneumatoceles are reviewed.

• Authors: M A Taube, G M Potter, S K Lloyd, S R Freeman
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 131 Issue 2 Pg. 181-184 (Feb 2017) ISSN: 1748-5460 [Electronic] England
• PMID: 28067182 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Bone Diseases (complications, diagnostic imaging, therapy)
• Conservative Treatment
• Craniocerebral Trauma (complications)
• Humans
• Hypoglossal Nerve Diseases (diagnosis, etiology, therapy)
• Hypoglossal Nerve Injuries (complications, diagnostic imaging, therapy)
• Male
• Mastoid (diagnostic imaging)
• Middle Aged
• Pneumocephalus (complications, diagnostic imaging, therapy)
• Temporal Bone (diagnostic imaging)
• Tomography, X-Ray Computed