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Clinical features and radiological evaluation of otic capsule sparing temporal bone fractures

Published online by Cambridge University Press:  26 January 2017

S W Song
Affiliation:
Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea
B C Jun*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, College of Medicine, Catholic University of Korea, Seoul, Korea
H Kim
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, College of Medicine, Catholic University of Korea, Seoul, Korea
*
Address for correspondence: Dr Beom Cho Jun, Department of Otolaryngology – Head and Neck Surgery, Catholic University of Korea – Uijeongbu, St Mary's Hospital, #65-1 Geumo-Dong, Uijeongbu City, Gyeonggi-Do, 480-717, Korea Fax: +82 31 847 0038 E-mail: [email protected]

Abstract

Objective:

To evaluate the clinical and radiological aspects of otic capsule sparing temporal bone fractures.

Methods:

Using medical records, 188 temporal bones of 173 patients with otic capsule sparing temporal bone fractures were evaluated. Otoscopic findings and symptoms, facial paralysis, and hearing loss were assessed.

Results:

Using regional analysis, 7 fractures were classified as type I, 85 as type II, 169 as type III and 114 as type IV. Fourteen of the 17 facial paralysis cases improved to House–Brackmann grade II or lower at an average of 57.6 days after the initial evaluation. Thirty-one patients underwent initial and follow-up pure tone audiometry examinations. The air–bone gap closed significantly from 27.2 dB at an average of 21.8 days post-trauma to 19.6 dB at an average of 79.9 days post-trauma, without the need for surgical intervention.

Conclusion:

Initial conservative treatment for facial paralysis or conductive hearing loss is possible in otic capsule sparing fracture cases after careful evaluation of the patient.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Brodie, HA, Thompson, TC. Management of complications from 820 temporal bone fractures. Am J Otol 1997;18:188–97Google Scholar
2 Nageris, B, Hansen, MC, Lavelle, WG, Van Pelt, FA. Temporal bone fractures. Am J Emerg Med 1995;12:211–14Google Scholar
3 Saraiya, PV, Aygun, N. Temporal bone fractures. Emerg Radiol 2009;16:255–65Google Scholar
4 Ishman, SL, Friedland, DR. Temporal bone fractures: traditional classification and clinical relevance. Laryngoscope 2004;114:1734–41Google Scholar
5 Cannon, CR, Jahrsdoerfer, RA. Temporal bone fractures: review of 90 cases. Arch Otolaryngol 1983;109:285–8CrossRefGoogle ScholarPubMed
6 Kennedy, TA, Avey, GD, Gentry, LR. Imaging of temporal bone trauma. Neuroimaging Clin N Am 2014;24:467–86Google Scholar
7 Magliulo, G, Appiani, MC, Iannella, G, Artico, M. Petrous bone fractures violating otic capsule. Otol Neurotol 2012;33:1558–61Google Scholar
8 Dahiya, R, Keller, JD, Litofsky, NS, Bankey, PE, Bonassar, LJ, Megerian, CA. Temporal bone fractures: otic capsule sparing versus otic capsule violating clinical and radiographic considerations. J Trauma 1999;47:1079–83Google Scholar
9 Lim, JH, Jun, BC, Song, SW. Clinical feasibility of multiplanar reconstruction images of temporal bone CT in the diagnosis of temporal bone fracture with otic-capsule-sparing facial nerve paralysis. Indian J Otolaryngol Head Neck Surg 2013;65:219–24Google Scholar
10 Aguilar, EA 3rd, Yeakley, JW, Ghorayeb, BY, Hauser, M, Cabrera, J, Jahrsdoerfer, RA. High resolution CT scan of temporal bone fractures: association of facial nerve paralysis with temporal bone fractures. Head Neck Surg 1987;9:162–6Google Scholar
11 Kelly, KE, Tami, TA. Temporal bone and skull base trauma. In: Jackler, RK, Brackmann, DE, eds. Neurotology. St Louis: Mosby, 1994;1127–47Google Scholar
12 Yanagihara, N, Murakami, S, Nishihara, S. Temporal bone fractures inducing facial nerve paralysis: a new classification and its clinical significance. Ear Nose Throat J 1997;76:7986 CrossRefGoogle ScholarPubMed
13 Johnson, F, Semaan, MT, Megerian, CA. Temporal bone fracture: evaluation and management in the modern era. Otolaryngol Clin N Am 2008;41:597618 Google Scholar
14 Nosan, DK, Benecke, JE Jr, Murr, AH. Current perspective on temporal bone trauma. Otolaryngol Head Neck Surg 1997;117:6771 CrossRefGoogle ScholarPubMed
15 Coker, NJ, Kendall, KA, Jenkins, HA, Alford, BR. Traumatic intratemporal facial nerve injury: management rationale for preservation of function. Otolaryngol Head Neck Surg 1987;97:262–9Google Scholar
16 Ghorayeb, BY, Yeakley, JW, Hall, JW 3rd, Jones, BE. Unusual complications of temporal bone fractures. Arch Otolaryngol Head Neck Surg 1987;113:749–53Google Scholar
17 Darrouzet, V, Duclos, JY, Liguoro, D, Truilhe, Y, De Bonfils, C, Bebear, JP. Management of facial paralysis resulting from temporal bone fractures: our experience in 115 cases. Otolaryngol Head Neck Surg 2001;125:7784 CrossRefGoogle ScholarPubMed
18 Ohlrogge, M, Francis, HW. Temporal bone fracture. Otol Neurotol 2004;25:195–6Google Scholar
19 Grant, JR, Arganbright, J, Friedland, DR. Outcomes for conservative management of traumatic conductive hearing loss. Otol Neurotol 2008;29:344–9Google Scholar
20 Kristensen, S, Juul, A, Gammelgaard, NP, Rasmussen, OR. Traumatic tympanic membrane perforations: complications and management. Ear Nose Throat J 1989;68:503–16Google Scholar