Abstract
Objective
To illustrate the clinical features and management of pneumatocoele presenting with a trap-valve mechanism after cochlear implantation with lateral petrosectomy (LP) in comparison with literature.
Introduction
Pneumatocoele is a rare complication of cochlear implant (CI) surgery, generally managed with conservative treatments.
Methods
We describe a progressively increasing pneumatocoele with a trap-valve mechanism occurring one year after CI with LP, successfully managed with revision surgery. Literature review was performed on this topic.
Results
Our case was the second ever reported in literature. It appeared consequently to forceful nose-blowing in a patient with refractory nasal polyposis. Unlike the pneumatocoeles reported after standard CI, we advised revision surgery as well as in the case of pneumatocoele after staged LP and CI. In both the patients subcutaneous air collection occurred as a late complication and an insufficient Eustachian tube closure was disclosed, which is considered a complication of LP itself. Surgical management was necessary in consideration of the risk of ascending infections associated with Eustachian tube patency in LP with CI.
Conclusion
We consider surgical treatment mandatory in pneumatocoele after CI with LP, it is indeed the sentinel of the restoration of Eustachian tube patency and the potential prelude to major complications.
Additional information
Notes on contributors
Canzi Pietro
Canzi Pietro is Associate Professor in Otorhinolaryngology at the University of Pavia. Currently practicing as Otolaryngologist at the tertiary otologic referral centre of Pavia University Hospital, IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, with special interest in otoneurosurgery and deafness surgery.
Carlotto Elena
Carlotto Elena is currently Otolaryngologist at Department of Otolaryngology, S. Croce Hospital, Cuneo, Italy, with special interest in otoaudiology and vestibology. Previously Otolaryngology resident, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. She obtained her medical degree at University of Turin, Turin, Italy.
Minervini Domenico
Minervini Domenico is currently Otolaryngologist, practicing at Department of Otolaryngology, IRCCS Policlinico San Matteo Foundation, Italy, with special interest in otology and in pediatric audiology. Previously Otolaryngology resident, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia. He obtained his medical degree at University of Bari, Bari, Italy.
Simoncelli Anna
Simoncelli Anna is currently Neuroradiologist, practicing at Department of Diagnostic Radiology- Neuroradiology, IRCCS Policlinico San Matteo Foundation, Italy, with special interest in otoneuroradiology.
De Iasio Andrea
De Iasio Andrea is currently Otolaryngologist, Department of Otolaryngology, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy, with special interest in otology. Previously Otolaryngology resident, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. He obtained his medical degree at University of Campania, Luigi Vanvitelli, Caserta, Italy.
Ottoboni Ilaria
Ottoboni Ilaria is currently resident Otolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. She obtained her medical degree at University of Padua, Padua, Italy in 2019.
Chiapparini Luisa
Chiapparini Luisa is currently Head of Department of Diagnostic Radiology- Neuroradiology, IRCCS Policlinico San Matteo Foundation, Italy. Previously Neuroradiologist, Department of Diagnostics and Applied Technology, Neuroradiology Unit, Carlo Besta Neurological Institute, Milan, Italy.
Benazzo Marco
Benazzo Marco is Full Professor in Otorhinolaryngology at the University of Pavia. Currently Head of Department of Otolaryngology, IRCCS Policlinico San Matteo Foundation, Italy.