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Pneumocephalus and orbital emphysema associated with the use of an autoinflation device: a unique case report and review of the literature

  • A J Millington (a1), V Perkins (a1) and M A Salam (a1)



Autoinflation devices are commonly used for otitis media with effusion and Eustachian tube dysfunction. Generally, these are very safe devices, with few or no complications.

Case report

This paper presents a case study of pneumocephalus and orbital emphysema, associated with the use of an autoinflation device, in a 73-year-old woman with Eustachian tube dysfunction and otitis media with effusion, and a history of extensive endoscopic sinus surgery 13 years previously.


A literature review showed autoinflation-related pneumocephalus in patients with skull base defects relating to cranial surgery or tumours; however, this has not been described previously with the Otovent system or its use in relation to functional endoscopic sinus surgery. Given the theoretical risk of undetected bony abnormalities in post-operative functional endoscopic sinus surgery patients, it is suggested that autoinflation devices are used cautiously in patients with a history of sinus surgery.


Corresponding author

Author for correspondence: Mr Alexander Millington, c/o ENT Dept, Ipswich Hospital, Heath Road, Ipswich IP4 5PD, UK E-mail:


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Mr A Millington takes responsibility for the integrity of the content of the paper



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