Mastoid hyperpneumatization with atlantoaxial fistulization presenting as head rotation-induced aural fullness.
OBJECTIVE
To describe a unique presentation of mastoid hyperpneumatization with atlantoaxial air fistulization.


METHODS
Case report, 30-year-old male patient.


METHODS
Descriptive case report.


METHODS
Subjective aural fullness, with objective tympanogram changes, induced by head rotation.


RESULTS
The patient complained of left ear fullness exclusively and repeatedly during neck extension and head rotation to the right side. These head positional changes cause a change of pressure of the atlantoaxial intra-articular emphysematous air, and these fluctuations in pressure are transmitted through the communicating mastoid fistula to the middle ear and tympanic membrane, leading to the sensation of ear fullness.


CONCLUSIONS
We hereby describe the first case of mastoid hyperpneumatization fistulizing into the atlantoaxial joint and presenting with an ipsilateral aural fullness that occurs mainly during contralateral head rotation and extension. This is a characteristic clinical sign that has not been previously described.
Rameh
Charbel
C
Department of Otolaryngology-Head and Neck Surgery, Nord University Hospital, Marseille, France. charbelrameh@hotmail.com
Meller
Renaud
R
Magnan
Jacques
J
D000158:Acoustic Impedance Tests; D000328:Adult; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D004432:Ear, Middle / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004646:Emphysema / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D005402:Fistula / Q000000981:diagnostic imaging / Q000473:pathology*; D019416:Head Movements; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000473:pathology*; D011312:Pressure; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed