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颞骨骨折的治疗

Treatment of Temporal Bone Fractures.

作者信息

Diaz Rodney C, Cervenka Brian, Brodie Hilary A

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, California, United States.

出版信息

J Neurol Surg B Skull Base. 2016 Oct;77(5):419-29. doi: 10.1055/s-0036-1584197. Epub 2016 Jun 2.

Abstract

Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Assessment of facial nerve function as soon as possible following injury greatly facilitates clinical decision making. Use of prophylactic antibiotics in the setting of CSF leak is controversial; however, following critical analysis and interpretation of the existing classic and contemporary literature, we believe its use is absolutely warranted.

摘要

颞骨创伤性损伤可导致严重的发病或死亡,了解相关解剖结构、损伤的病理生理学以及适当的管理策略对于此类受伤患者的成功康复至关重要。大多数颞骨骨折由机动车事故引起。颞骨骨折最好分为保留听骨链或破坏听骨链型骨折,因为这种分类与伴随功能并发症的风险密切相关。颞骨骨折最常见的并发症是面神经损伤、脑脊液(CSF)漏和听力丧失。受伤后尽快评估面神经功能极大地有助于临床决策。在脑脊液漏的情况下使用预防性抗生素存在争议;然而,在对现有经典和当代文献进行批判性分析和解读后,我们认为其使用是绝对必要的。

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