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Post-traumatic temporal bone pneumatocele presenting after aggressive Valsalva
  1. Jacob Seicshnaydre1,
  2. Isaac Erbele2,3,
  3. Stephen Hernandez3,4 and
  4. Moisés Arriaga3
  1. 1Department of Otolaryngology, Louisiana State University School of Medicine in New Orleans, New Orleans, Louisiana, USA
  2. 2Department of Otolaryngology, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA
  3. 3Department of Otolaryngology—Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
  4. 4Head and Neck Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA
  1. Correspondence to Dr Moisés Arriaga; maa{at}


We report a case of a temporal bone pneumatocele with full-thickness erosion of the cranium associated with aggressive nose blowing. This condition presented 9 years after traumatic fracture of the temporal bone. There are 17 reported cases of mastoid sinus hyperpneumatisation in the literature. Eleven of the 17 are associated with Valsalva manoeuvres or elevated middle ear pressure. However, no other cases of full-thickness erosion at the site of a former fracture have been reported. We propose that the fracture, in combination with elevated mastoid sinus pressure from aggressive nose blowing, led to escape and trapping of pressurised air in the epidural and subcutaneous spaces, which resulted in bone erosion.

  • neurootology
  • trauma CNS /PNS
  • otolaryngology / ENT
  • neurosurgery
  • radiology

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  • Contributors Each author has read and approved the article. IE, SH, and MA were instrumental in the clinical course and treatment of the patient. JS was responsible for chart review and initial write up, which was reviewed and edited by all other authors. We have no conflicts of interest.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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