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

J Laryngol Otol. 2017 Mar;131(3):209-214. doi: 10.1017/S0022215117000123. Epub 2017 Jan 26.

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.

Keywords: Conductive Hearing Loss; Facial Paralysis; Fractures; Temporal Bone.

MeSH terms

  • Adult
  • Audiometry, Pure-Tone
  • Conservative Treatment
  • Facial Paralysis / etiology*
  • Female
  • Hearing Loss, Conductive / etiology*
  • Humans
  • Male
  • Middle Aged
  • Otoscopy
  • Radiography / methods
  • Retrospective Studies
  • Skull Fractures / classification
  • Skull Fractures / complications
  • Skull Fractures / diagnostic imaging*
  • Temporal Bone / diagnostic imaging
  • Temporal Bone / injuries*
  • Tympanic Membrane