Craniocervical pneumatization: Estimation of prevalence and imaging of treatment response

Courtney M. Tomblinson, Nicholas L. Deep, Steven M. Weindling, John I. Lane, Linsey S. Scheibler, David M. Barrs, Joseph M. Hoxworth

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: Estimate the prevalence of craniocervical pneumatization (CCP) and describe successful treatment of this condition with clinical and radiologic correlation. Patients: Individuals with documented CCP on computed tomography (CT). Intervention(s): CT scans of the head, temporal bone, face, neck, and cervical spine. Cessation of habitual Valsalva maneuver (VM) and insertion of pressure-equalization (PE) tubes. Main Outcome Measure: The prevalence of CCP on CT examinations performed during two decades in a large academic healthcare system. Documentation of symptomatic and imaging improvement following treatment of CCP. Results: Radiology database review identified two cases of CCP out of a total of 636,854 head and neck CT scans (0.00031%) or 43,553 temporal bone CT scans (0.0046%). Both CCP patients were symptomatic (aural fullness, hearing loss, vertigo) and practiced habitual VM. One patient showed decreased CCP 4 months following cessation of VM, whereas the other patient improved symptomatically and demonstrated reversion of CCP to normal bone on magnetic resonance imaging (MRI) within 3 years following PE tube placement. Conclusions: Acquired CCP is exceedingly rare and, when successfully treated, reversion to normal bone may accompany symptom resolution.

Original languageEnglish (US)
Pages (from-to)708-712
Number of pages5
JournalOtology and Neurotology
Issue number6
StatePublished - Jul 1 2016


  • Cervical spine
  • Craniocervical pneumatization
  • Hyperpneumatization
  • Pneumocranium
  • Pressure equalization tubes
  • Skull base
  • Temporal bone

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology


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