Craniocervical Pneumatization: Estimation of Prevalence and Imaging of Treatment Response.

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Craniocervical Pneumatization: Estimation of Prevalence and Imaging of Treatment Response.

Otol Neurotol. 2016 Jul;37(6):708-12

Authors: Tomblinson CM, Deep NL, Weindling SM, Lane JI, Scheibler LS, Barrs DM, Hoxworth JM

Abstract
OBJECTIVE: Estimate the prevalence of craniocervical pneumatization (CCP) and describe successful treatment of this condition with clinical and radiologic correlation.
PATIENTS: Individuals with documented CCP on computed tomography (CT).
INTERVENTION(S): CT scans of the head, temporal bone, face, neck, and cervical spine. Cessation of habitual Valsalva maneuver (VM) and insertion of pressure-equalization (PE) tubes.
MAIN OUTCOME MEASURE: The prevalence of CCP on CT examinations performed during two decades in a large academic healthcare system. Documentation of symptomatic and imaging improvement following treatment of CCP.
RESULTS: Radiology database review identified two cases of CCP out of a total of 636,854 head and neck CT scans (0.00031%) or 43,553 temporal bone CT scans (0.0046%). Both CCP patients were symptomatic (aural fullness, hearing loss, vertigo) and practiced habitual VM. One patient showed decreased CCP 4 months following cessation of VM, whereas the other patient improved symptomatically and demonstrated reversion of CCP to normal bone on magnetic resonance imaging (MRI) within 3 years following PE tube placement.
CONCLUSIONS: Acquired CCP is exceedingly rare and, when successfully treated, reversion to normal bone may accompany symptom resolution.

PMID: 27050653 [PubMed - indexed for MEDLINE]

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