Pneumolabyrinth: etiopathogenesis, clinical presentation, treatment and outcome

Pneumolabyrinth (PNL) is a relativity rare radiologic finding defined as the presence of air inside the inner ear. It is usually associated with the presence of a perilymphatic fistula. Only case reports or small case series on this topic are reported in the scientific literature. For this reason, the management of PNL has not been established and still remains a controversial problem in otologic clinical practice. Multiple treatment options are available, conservative or surgical, with good impact on vestibular outcome, but with unsatisfactory results on hearing function. Hearing loss can be irreversible even after medical or surgical treatment with the closure of the perilymphatic fistula. The level of evidence is still lo low to make a definite algorithm for the clinical management of pneumolabyrinth, and not all authors agree on treatment strategies. The aim of this paper was to perform a literature review on etiopathogenesis, clinical presentation, treatment, and outcome of pneumolabyrinth, in order to clarify the current available information about this condition.