{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:49:09Z","timestamp":1756385349665},"reference-count":9,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2014,2,20]],"date-time":"2014-02-20T00:00:00Z","timestamp":1392854400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215114000097_sec1\"><jats:title>Background:<\/jats:title><jats:p>Hyperpneumatisation of the skull base and upper cervical vertebrae is a very rare condition of uncertain aetiology and pathophysiology.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215114000097_sec2\"><jats:title>Case report:<\/jats:title><jats:p>A case of extensive hyperpneumatisation of the craniocervical junction and upper three cervical vertebrae is described, in a patient who habitually performed the Valsalva manoeuvre to relieve the symptoms of a patulous eustachian tube. Reported symptoms of ear, neck and shoulder pain deteriorated after minor head trauma. There was a drastic radiological and clinical improvement after ceasing to perform the Valsalva manoeuvre.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215114000097_sec3\"><jats:title>Discussion:<\/jats:title><jats:p>All reported cases of craniocervical bone hyperpneumatisation have in common a history of raised middle-ear pressure, minor trauma or both. We therefore suggest that chronically raised middle-ear pressure leads to destruction of bony tissue and pneumatisation, and that this process is able to cross joints into the cervical spine, either via micro-fractures following trauma, or as a result of congenital assimilation of the craniocervical junction.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215114000097","type":"journal-article","created":{"date-parts":[[2014,2,20]],"date-time":"2014-02-20T08:53:09Z","timestamp":1392886389000},"page":"381-384","source":"Crossref","is-referenced-by-count":2,"title":["Hyperpneumatisation of the craniocervical bones: an emerging aetiological pattern"],"prefix":"10.1017","volume":"128","author":[{"given":"J M","family":"Fussey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"El-Maghraby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Rejali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2014,2,20]]},"reference":[{"key":"S0022215114000097_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100051744"},{"key":"S0022215114000097_ref5","first-page":"491","article-title":"Progressive calvarial and upper cervical pneumatisation associated with habitual valsalva manoeuvre in a 70-year-old man","volume":"25","author":"Littrell","year":"2004","journal-title":"Am J Neuroradiol"},{"key":"S0022215114000097_ref1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.145.3.473"},{"key":"S0022215114000097_ref4","first-page":"1398","article-title":"Cutaneous emphysema and craniocervical bone pneumatisation","volume":"22","author":"Turowski","year":"2001","journal-title":"Am J Neuroradiol"},{"key":"S0022215114000097_ref9","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.14.2.8190952"},{"key":"S0022215114000097_ref7","doi-asserted-by":"publisher","DOI":"10.3171\/2011.9.SPINE11443"},{"key":"S0022215114000097_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182283102"},{"key":"S0022215114000097_ref3","first-page":"1231","article-title":"Mastoid pneumocele causing atlantooccipital pneumatisation","volume":"19","author":"Martin","year":"1998","journal-title":"Am J Neuroradiol"},{"key":"S0022215114000097_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/BF00596581"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215114000097","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T18:05:09Z","timestamp":1555956309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215114000097\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,20]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["S0022215114000097"],"URL":"https:\/\/doi.org\/10.1017\/s0022215114000097","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,20]]}}}