Pneumolabyrinth, the presence of air within the labyrinth, is a rare radiologic finding associated with a well-known perilymphatic fistula (PLF). As there are only 24 published case reports in medical literature, multiple treatment options for the pneumolabyrinth are available. We report a case of a 20-year-old man with a pneumolabyrinth secondary to tympanic membrane and ossicular trauma. Despite conservative treatment, sensorineural hearing loss (SNHL) had progressed rapidly, and his profound deafness had not recovered after surgical exploration with closure of the PLF. Functional prognostic factors of SNHL are revised and compared with this case.