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.

PATIENTS: Case report, 30-year-old male patient.

INTERVENTIONS: Descriptive case report.

MAIN OUTCOME MEASURES: 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.

CONCLUSION

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.