Ministry of Justice Council of Forensic Medicine, Istanbul, Turkey.
Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul University, Istanbul, Turkey.
J Int Adv Otol. 2021 May;17(3):239-244. doi: 10.5152/iao.2021.9089.
The purpose of the study is to evaluate the audiological, radiological, and examination findings of patients who have been treated for hearing loss (HL) due to head trauma and evaluated in terms of causality to reveal current data, and to highlight the steps to be taken.
We retrospectively reviewed the reports of cases that had applied for disability with HL due to head injury and had been evaluated by the Forensic Medicine Institute between January 01, 2009 and January 01, 2019.
Of the total cases of head trauma, 52.42% were not vehicle-related, and cases were observed to be concentrated in the age range of 19-40 (55.92%; n = 283). Although otorrhagia/otorrhea was the most common finding in all types of trauma, TM perforation was the most common finding in blast-type injuries. While the rate of newly developed unilateral HL was 84.2%, 72.7% of the patients had sensorineural hearing loss (SNHL) . Temporal bone fractures were detected in 59.3% of the cases, and 60.2% of them were of the longitudinal type. Facial paralysis (FP) was detected in 28.6% of the cases, and there was no statistically significant difference between the groups in terms of HL compared to those without FP. Other nerve palsy was detected in 4.9% of the cases, and N. Abducens paralysis was the most common.
Accompanying intracranial nerve injury, temporal fracture, and intracranial pathologies are considerably high in patients who develop HL following head trauma. The first examination requires a multidisciplinary approach to guide future disability applications.
本研究旨在评估因头部外伤导致听力损失（HL）并接受因果关系评估的患者的听力学、影像学和检查结果，以揭示当前数据，并强调应采取的步骤。
我们回顾性分析了 2009 年 1 月 1 日至 2019 年 1 月 1 日期间，因头部外伤导致 HL 并向法医研究所申请残疾评估的病例报告。
在所有头部外伤病例中，52.42%与车辆无关，且病例集中在 19-40 岁年龄组（55.92%；n=283）。虽然所有类型创伤中最常见的发现是耳漏/耳溢，但在爆炸伤中最常见的发现是鼓膜穿孔。虽然新发性单侧 HL 的发生率为 84.2%，但 72.7%的患者有感觉神经性听力损失（SNHL）。59.3%的病例检测到颞骨骨折，其中 60.2%为纵行型。28.6%的病例检测到面瘫（FP），FP 组与无 FP 组在 HL 方面无统计学差异。4.9%的病例检测到其他神经麻痹，最常见的是展神经麻痹。
头部外伤后发生 HL 的患者伴发颅内神经损伤、颞骨骨折和颅内病变的比例相当高。首次检查需要多学科方法来指导未来的残疾申请。
