Spontaneous Otogenic Pneumocephalus: Reporting a Unique Site of Dehiscence

Pneumocephalus is the presence of air in the intracranial space and is usually caused by trauma, tumor, or infection.1 Spontaneous occurrences of pneumocephalus, however, are very rare and generally result from a skull base defect.2 In this report, we present a case of spontaneous otogenic pneumocephalus that developed during an airplane flight. We believe that this is the first report of spontaneous pneumocephalus involving the petrous apex. A combined right transmastoid and middle fossa surgical approach was performed to repair the defect, followed by no recurrence of symptoms