Song S W, Jun B C, Kim H
Department of Radiology,College of Medicine,Catholic University of Korea,Seoul,Korea.
Department of Otolaryngology - Head and Neck Surgery,College of Medicine,Catholic University of Korea,Seoul,Korea.
J Laryngol Otol. 2017 Mar;131(3):209-214. doi: 10.1017/S0022215117000123. Epub 2017 Jan 26.
To evaluate the clinical and radiological aspects of otic capsule sparing temporal bone fractures.
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.
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.
Initial conservative treatment for facial paralysis or conductive hearing loss is possible in otic capsule sparing fracture cases after careful evaluation of the patient.
评估保留听骨囊的颞骨骨折的临床和影像学特征。
利用病历资料,对173例保留听骨囊的颞骨骨折患者的188块颞骨进行评估。评估耳镜检查结果及症状、面瘫和听力损失情况。
采用区域分析,7例骨折分类为I型,85例为II型,169例为III型,114例为IV型。17例面瘫患者中有14例在初次评估后平均57.6天改善至House-Brackmann II级或更低级别。31例患者接受了初次及随访纯音听力测定检查。气骨导间距从创伤后平均21.8天的27.2 dB显著缩小至创伤后平均79.9天的19.6 dB,无需手术干预。
在对患者进行仔细评估后,保留听骨囊的骨折病例中,面瘫或传导性听力损失初期可行保守治疗。