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Hyperpneumatisation of the craniocervical bones: an emerging aetiological pattern

Published online by Cambridge University Press:  20 February 2014

J M Fussey ,
H El-Maghraby  and
D Rejali
J M Fussey*
Affiliation:
Department of Otolaryngology, University Hospital Coventry, UK
H El-Maghraby
Affiliation:
Department of Neurosurgery, University Hospital Coventry, UK
D Rejali
Affiliation:
Department of Otolaryngology, University Hospital Coventry, UK
*
Address for correspondence: Mr Jonathan Mark Fussey, Department of ENT Surgery, University Hospital Coventry, Clifford Bridge Rd, Coventry CV2 2DX, UK Fax: +44 (0)247 6966462 E-mail: jfussey@doctors.org.uk
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Abstract

Background:

Hyperpneumatisation of the skull base and upper cervical vertebrae is a very rare condition of uncertain aetiology and pathophysiology.

Case report:

A case of extensive hyperpneumatisation of the craniocervical junction and upper three cervical vertebrae is described, in a patient who habitually performed the Valsalva manoeuvre to relieve the symptoms of a patulous eustachian tube. Reported symptoms of ear, neck and shoulder pain deteriorated after minor head trauma. There was a drastic radiological and clinical improvement after ceasing to perform the Valsalva manoeuvre.

Discussion:

All reported cases of craniocervical bone hyperpneumatisation have in common a history of raised middle-ear pressure, minor trauma or both. We therefore suggest that chronically raised middle-ear pressure leads to destruction of bony tissue and pneumatisation, and that this process is able to cross joints into the cervical spine, either via micro-fractures following trauma, or as a result of congenital assimilation of the craniocervical junction.

Keywords

Skull BaseEustachian TubeEar, MiddleValsalva Maneuver
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 4 , April 2014 , pp. 381 - 384
Copyright
Copyright © JLO (1984) Limited 2014 

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