Waldron J, Hurley S E
Department of Ear Nose and Throat Surgery, St Mary's Hospital, London, England.
Arch Emerg Med. 1988 Sep;5(3):146-50. doi: 10.1136/emj.5.3.146.
Temporal bone fractures may be complicated by intracranial haemorrhage, C.S.F. leakage and infection, damage to the middle and inner ear and damage to the seventh and eighth cranial nerves. Accurate early diagnosis is important to enable adequate investigation and prompt treatment of any complications. We present eight cases seen in a 12 month period in which a temporal bone fracture was not diagnosed at presentation in spite of a full clinical examination and standard skull radiographs. Five of these cases developed complications which resulted in their referral. The absence of a visible fracture on plain skull radiographs does not exclude a fracture, and those patients with clinical signs of a fracture should be treated appropriately and further investigations performed. Therefore the clinical examination is vital in diagnosing temporal bone fractures and must include careful otoscopy together with assessment of the function of the seventh and eighth cranial nerves.
颞骨骨折可能并发颅内出血、脑脊液漏和感染、中耳和内耳损伤以及第七和第八颅神经损伤。准确的早期诊断对于进行充分的检查和及时治疗任何并发症至关重要。我们报告了在12个月期间所见的8例病例，尽管进行了全面的临床检查和标准的颅骨X线片检查，但在就诊时颞骨骨折仍未被诊断出来。其中5例发生了并发症，导致他们被转诊。颅骨平片上未见明显骨折并不能排除骨折，有骨折临床体征的患者应得到适当治疗并进行进一步检查。因此，临床检查对于诊断颞骨骨折至关重要，必须包括仔细的耳镜检查以及对第七和第八颅神经功能的评估。
