Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea.
PLoS One. 2019 May 31;14(5):e0217682. doi: 10.1371/journal.pone.0217682. eCollection 2019.
We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF).
Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction.
Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025).
The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs.
我们假设，当颞骨骨折发生时，颞骨中的气房能够在创伤事件中吸收大部分冲击力。本研究旨在探讨颞骨气房发育程度与颞骨骨折（TBF）严重程度的关系。
回顾性分析了 2012 年至 2017 年期间在一家三级医院诊断的 54 例 TBF 患者的病历和计算机断层扫描（CT）图像。使用先前发表的分类系统评估岩骨尖和乳突区的颞骨气房发育程度（TBP）。将 TBP 分类和骨折类型与 TBF 并发症（如感音神经性听力损失（SNHL）、面神经麻痹（FNP）和前庭功能障碍）进行相关性分析。
颞骨气房发育程度较高的患者 SNHL 的发生率和严重程度明显较低。SNHL 与乳突气房发育程度的相关性（P=0.005）明显强于岩骨尖气房发育程度（P=0.024）。另一方面，TBP 程度与 FNP 和前庭功能障碍的相关性较差。然而，乳突气房发育不全与骨迷路破坏有显著相关性（P=0.002）。有骨迷路破坏的骨折发生前庭功能障碍的可能性增加 4 倍（P=0.043），发生 SNHL 的可能性增加 3 倍（P=0.006）。FNP 与骨迷路破坏骨折无关，但在粉碎性骨折中更为常见（P=0.025）。
颞骨骨折患者的颞骨气房发育程度与骨迷路破坏和听力损伤的严重程度呈负相关。本研究证实了颞骨气房发育在 TBF 中的潜在保护作用。
