Air Embolism as a Complication of Inflation of the Tympanum Through the External auditory meatus A Clinico-Pathological Study of a Fatal Case

Abstract

A case is described of fatal air embolism resulting from tympanic inflation carried out through the external auditory meatus for the treatment of secretory otitis media. The post-mortem findings, including the result of a histological examination of the temporal bone, provide evidence that the air left the tympanum through one or more small natural defects in the tegmen-tympani and passed forwards outside the dura to the region of the foramen lacerum medium. Here it caused surgical emphysema of the peri-carotid connective tissue and entered the venous system by rupturing the thin-walled venous sinuses which are present at this point. Thereafter the air passed by way of the cavernous and petrosal sinuses to the right side of the heart and so caused death.