Kahn J B, Stewart M G, Diaz-Marchan P J
Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.
Am J Otol. 2000 Sep;21(5):743-52.
To determine the clinical utility of high-resolution computed tomography (HRCT) for temporal bone trauma evaluation and management.
Retrospective review.
Level I trauma center.
Patients (n = 105) with evidence of temporal bone trauma.
Statistically significant associations between HRCT, clinical, audiometric, and head CT findings, and management decisions; role of HRCT in management decisions.
Statistical analysis demonstrated poor association between specific clinical and HRCT findings, and between HRCT findings and management decisions. The HRCT complemented decision making in 10% of cases and revealed asymptomatic carotid canal fractures in 9% of cases.
Routine HRCT yields minimal clinical utility. Selective use of HRCT may complement decision making, but patient management is predominantly influenced by other factors. Although angiography was performed in cases of asymptomatic carotid canal fractures, no clinical utility for this practice was demonstrated. An algorithm for temporal bone trauma evaluation and management is presented.
确定高分辨率计算机断层扫描（HRCT）在颞骨创伤评估与处理中的临床应用价值。
回顾性研究。
一级创伤中心。
有颞骨创伤证据的患者（n = 105）。
HRCT、临床、听力测定及头部CT检查结果之间具有统计学意义的关联，以及处理决策；HRCT在处理决策中的作用。
统计分析表明，特定临床与HRCT检查结果之间，以及HRCT检查结果与处理决策之间的关联较弱。HRCT在10%的病例中辅助了决策制定，在9%的病例中发现了无症状的颈动脉管骨折。
常规HRCT的临床应用价值极小。选择性使用HRCT可能辅助决策制定，但患者的处理主要受其他因素影响。尽管对无症状的颈动脉管骨折病例进行了血管造影，但未证明该做法有临床应用价值。本文提出了一种颞骨创伤评估与处理的算法。
