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Acute pneumolabyrinth: a rare complication after cochlear implantation in a patient with obstructive sleep apnoea on CPAP therapy
  1. Angelo Immordino1,
  2. Francesco Lorusso2,
  3. Federico Sireci2 and
  4. Francesco Dispenza1
  1. 1Biomedicine, Neuroscience and Advanced Diagnostics, Università degli Studi di Palermo, Palermo, Sicilia, Italy
  2. 2U.O.C. Otorinolaringoiatria, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Sicilia, Italy
  1. Correspondence to Dr Francesco Dispenza; francescodispenza{at}


Pneumolabyrinth is a condition characterised by the presence of air within the inner ear and is a rare complication after cochlear implant surgery. One of the causes of pneumolabyrinth may be the increase in pressure in the middle ear. The use of continuous positive airway pressure (CPAP) is an effective treatment strategy for obstructive sleep apnoea. According to a recent study, the use of CPAP should be delayed by 1 or 2 weeks in subjects undergoing middle ear surgery; however, there is currently no indication to delay the CPAP in subjects undergoing cochlear implant surgery. We report the case of a patient on CPAP who underwent left cochlear implantation and, in the early postoperative period, reported severe vertigo and tinnitus. Cone-beam CT of the temporal bone revealed the presence of pneumolabyrynth. We believe that the use of CPAP should be delayed in subjects undergoing cochlear implantation to avoid the development of acute pneumolabyrinth.

  • CPAP
  • Ear, nose and throat/otolaryngology
  • Radiology
  • Otolaryngology / ENT

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  • Contributors All authors have contributed to paper realisation. Conceptualisation: FD and AI. Methodology: FD and AI. Validation: FD. Investigation: FL and FS. Resources: FL and FS. Writing—original draft preparation: AI. Writing—review and editing: FD. Project administration: FD. All authors have read and agreed to the published version of the manuscript.

  • 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.