[Severe temporal bone fractures in children: clinical presentation, complications and sequelae observed in the last 11 years]

Abstract

Objectives: To evaluate the clinical presentation, complications and sequelae in patients with temporal bone fracture in the last 11 years.

Material and methods: A total of 27 patient medical records were retrospectively analysed.

Results: Of the 27 patients who were admitted for temporal bone fracture from 2001 to 2012, 13 (48%) had no petrous involvement (Group 1), and 14 (52%) with petrous involvement (Group 2). Patients in Group 2 had a longer P-ICU stay: median 4.5 days (RI: 2.75-22.25 d) vs 2 (RI: 1-3 d) (P=.018); more days on mechanical ventilation support: median 3 days (RI: 1.50-17 d) vs 1 (RI: 1-1.25 d). This group also had a higher frequency in sequelae (P=.04 OR=1.4 (95% CI: 1.05-1.95)) and a higher incidence in cerebrospinal fluid (CSF) fistula (P<.02; OR 2.33; 95% CI (1.27-4.27)). Severity scores (PRIMS III and PTI) showed no significant differences. Some degree of hearing loss was observed in 31% of the patients. Traffic accident was the main cause of trauma (33%), followed by falls (27%). There were 2 deaths and 4 (15%) had permanent sequelae.

Conclusions: Isolated temporal bone fractures usually have a good outcome in children, but in some cases they can be fatal or have permanent sequelae. Long term follow up is recommended by authors.

Keywords: Cerebrospinal fluid fistula; Fractura de hueso temporal; Fístula de líquido cefalorraquídeo; Hearing loss; Pérdida auditiva; Temporal bone fracture.