title: Late pneumolabyrinth after undiagnosed post-traumatic perilymphatic fistula. Case report illustrating the importance of systematic emergency management.
abstract: BACKGROUND
  Temporal bone fracture is a common complication of high-energy cranial trauma. Labyrinth involvement is rare, but there is a risk of perilymphatic rupture that is often underestimated on initial clinical examination due to the predominance of neurological and/or somatic symptoms.
  
  
  METHODS
  A patient presented with overlooked perilymphatic fistula, decompensated by hyperpressure effort due to poorly adapted management.
  
  
  CONCLUSIONS
  Following a review of the literature on post-traumatic pneumolabyrinth, overall management (from diagnosis to treatment, via prevention advice) was analyzed. A constructive critique of the patient's treatment was thus made.
  
  
  CONCLUSIONS
  We argue for a systematic management protocol in cranial trauma with temporal bone fracture, comprising ENT examination, millimetric-scale cross-sectional imaging of the fracture site, and standardized counseling to prevent late complications.
authors.affiliation: Service d'Oto-Rhino-Laryngologie et Chirurgie de la Face et du Cou, Assistance Publique-Hôpitaux de Marseille, CHU Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: M
authors.initials: M
authors.lastname: Achache
authors.forename: M
authors.initials: M
authors.lastname: Sanjuan Puchol
authors.forename: L
authors.initials: L
authors.lastname: Santini
authors.forename: B
authors.initials: B
authors.lastname: Lafont
authors.forename: M
authors.initials: M
authors.lastname: Cihanek
authors.forename: J P
authors.initials: JP
authors.lastname: Lavieille
authors.forename: A
authors.initials: A
authors.lastname: Devèze
mesh_terms: D000328:Adult; D000388:Air; D003052:Cochlear Aqueduct / Q000293:injuries* / Q000601:surgery; D015834:Cochlear Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D057210:Delayed Diagnosis; D004630:Emergencies; D005402:Fistula / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D003639:Hearing Loss, Sudden / Q000209:etiology; D006801:Humans; D007759:Labyrinth Diseases / Q000209:etiology* / Q000601:surgery; D008297:Male; D008337:Mandibular Fractures / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008575:Meniere Disease / Q000209:etiology; D010498:Perilymph; D011856:Radiographic Image Enhancement; D011858:Radiographic Magnification; D012887:Skull Fractures / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013199:Stapes / Q000293:injuries; D013701:Temporal Bone / Q000293:injuries*; D014012:Tinnitus / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
keywords: CT-scan; Emergency trauma care; Perilymphatic fistula; Pneumolabyrinth; Temporal bone fracture