Lethal Intracranial Complications Following Inflation in the External Auditory Canal in Treatment of Serous Otitis Media and Due to Defects in the Petrous Bone

Abstract

A case with lethal intracranial complications following paracentesis and inflation with a Politzer balloon in the external auditory canal is reported. Demonstration of tegmental bone defects affords an anatomical precondition for propagation of the air pressure wave from the external auditory canal to the intracranial cavity. In the present case the pressure wave caused two complications, each dangerous to life:

(1) emphysematous detachment of the dura over the legmen tympani with sudden increase in intracranial pressure, resulting in diffuse and severe brain damage, and

(2) epidural hematoma secondary to vascular injury following detachment of the dura.

In 94 autopsies selected at random extensive defects in the tegmental bone covering the middle ear were found in about six per cent.