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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

Published online by Cambridge University Press:  09 January 2017

M A Taube ,
G M Potter ,
S K Lloyd  and
S R Freeman
M A Taube
Affiliation:
Department of Otolaryngology, Salford Royal NHS Foundation Trust, UK Faculty of Medical and Human Sciences, University of Manchester, UK
G M Potter
Affiliation:
Department of Neuroradiology, Salford Royal NHS Foundation Trust, UK
S K Lloyd
Affiliation:
Department of Otolaryngology, Salford Royal NHS Foundation Trust, UK Institute of Cancer Sciences, University of Manchester, UK
S R Freeman*
Affiliation:
Department of Otolaryngology, Salford Royal NHS Foundation Trust, UK
*
Address for correspondence: Mr Simon R Freeman, Department of Otolaryngology, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK Fax: 0161 206 4723 E-mail: simon.freeman@srft.nhs.uk
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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.

Keywords

PneumocephalusMastoidHypoglossal Nerve
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 2 , February 2017 , pp. 181 - 184
Copyright
Copyright © JLO (1984) Limited 2017 

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