Acute pneumolabyrinth: a rare complication after cochlear implantation in a patient with obstructive sleep apnoea on CPAP therapy

• Published in: BMJ case reports Vol. 16; no. 6; p. e254069
• Main Authors: Immordino, Angelo, Lorusso, Francesco, Sireci, Federico, Dispenza, Francesco
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 30.06.2023; BMJ Publishing Group
• Subjects: Acoustics; Asymmetry; Biofeedback; Case reports; Case Reports: Findings that shed new light on the possible pathogenesis of a disease; Cochlear Implantation - adverse effects; Cochlear implants; Continuous positive airway pressure; Continuous Positive Airway Pressure - adverse effects; Electrodes; Fistula; Fractures; Hearing loss; Humans; Iatrogenesis; Medical imaging; Muscle contraction; Patients; Sleep apnea; Sleep Apnea, Obstructive - therapy; Surgery; Tinnitus; Treatment Outcome; Vertigo; Radiology; CPAP; Ear, nose and throat/otolaryngology; Otolaryngology / ENT
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2022-254069

Pneumolabyrinth is a condition characterised by the presence of air within the inner ear and is a rare complication after cochlear implant surgery. One of the causes of pneumolabyrinth may be the increase in pressure in the middle ear. The use of continuous positive airway pressure (CPAP) is an effective treatment strategy for obstructive sleep apnoea. According to a recent study, the use of CPAP should be delayed by 1 or 2 weeks in subjects undergoing middle ear surgery; however, there is currently no indication to delay the CPAP in subjects undergoing cochlear implant surgery. We report the case of a patient on CPAP who underwent left cochlear implantation and, in the early postoperative period, reported severe vertigo and tinnitus. Cone-beam CT of the temporal bone revealed the presence of pneumolabyrynth. We believe that the use of CPAP should be delayed in subjects undergoing cochlear implantation to avoid the development of acute pneumolabyrinth.