Pediatric pneumolabyrinth: managing otologic trauma.

Background: Penetrating middle ear trauma-induced pneumolabyrinth is an exceedingly rare finding in pediatric patients. This condition can lead to significant hearing and vestibular dysfunction. We present two pediatric cases, highlighting their clinical complexity.

Methods: Case 1 presented a 9-year-old boy with hearing loss, vertigo, and vomiting following a penetrating trauma to the left ear. Surgical exploration revealed ossicular chain disruption and perilymphatic fistula, which were repaired. Despite initial recovery, he developed ossifying labyrinthitis and required cochlear implantation. Case 2 described a 15-year-old boy who had right-sided hearing loss and vertigo after right ear trauma. Conservative management resulted in improvement of vestibular symptoms, but the profound hearing loss remained. The family declined cochlear implantation, due to the patient's athletic activities.

Conclusions: Penetrating trauma-induced pneumolabyrinth in pediatric patients is extremely rare. These cases demonstrate the importance of tailored treatment approaches and vigilant follow-up to optimize auditory and vestibular outcomes.