A Study of Otological Manifestations of Temporal Bone Fractures
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ORIGINAL ARTICLE
A Study of Otological Manifestations of Temporal Bone Fractures B. K. Prasad1 • A. Basu1 • P. K. Sahu1 • A. K. Rai1
Received: 8 July 2020 / Accepted: 25 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract The aim of study was to evaluate various otological manifestations of temporal bone fractures and to suggest their management. This prospective observational study was conducted in a tertiary care hospital of Armed Forces over 2.5 years in 57 cases of temporal bone fracture in patients of age group of 12–59 yrs comprising 49 males and 8 females. Radioimaging was done for diagnosing the fracture, mapping its extent and for clinical correlation. Hearing was assessed by tuning forks, free field hearing and pure tone audiogram as per the fitness of patient. Majority of patients were in the age group 20–40 years who had met with road accidents. Important otological features included Battle sign (24.6%), ear canal laceration (53%), tympanic membrane perforation (7%), haemotymanum (40%), ear discharge (66.7%), hearing loss (63%), vertigo (16%), tinnitus (21%), facial paralysis (68%) and cerebrospinal fluid otorrhea (3.5%). Otic capsule sparing fracture was three times more common than violating ones. Facial palsies were treated with oral steroid with complete recovery in 56.41% cases but three required decompression surgery. 4 patients underwent tympanoplasty. Both the cerebrospinal fluid leaks stopped in 2 weeks time. Facial palsy is as common as hearing loss. TM perforation is as rare as CSF leak. Otic capsule violating fracture line is less common. Hearing loss shows recovery in most of the cases. Delayed onset positional vertigo is more common than acute vertigo. Large numbers of immediate onset complete facial palsy do recover from injury without surgery.
& B. K. Prasad [email protected] 1
Department of ENT and HNS, Command Hospital (Central Command), Lucknow, Uttar Pradesh 266002, India
Keywords Fracture Temporal Bone Facial Palsy Hearing Loss Vertigo Battle Sign CSF Otorrhea
Introduction With the increase in incidents of automobile accidents, there has been significant increase in the mortality and morbidity of the victims. According to an Indian study, approx 75% of road traffic accidents results in head injury [1]. Temporal bone fracture, being extremely common in head injury, renders the ears as the most frequently affected sense organ of the body [2]. A temporal bone fracture can involve one or more vital structures it houses, namely cochlea, vestibular end organ, facial nerve, carotid artery and jugular vein. Situation can worsen with associated closed head injury, spinal fractures, maxillofacial trauma and cranial nerves involvement. The management of life threatening injuries always takes priority, hence otological manifestation may be overlooked. In such scenario, treatment of otological problems becomes difficult, resulting in compromise in quality of life. A study was hence conducted to document various otological manifestations of temporal bone fract
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