Venugopalan Shruti, Mehta Manish R, Khavdu Paresh J, Fefar Alpesh D, Mistry Sejal N
Department of Otorhinolaryngology, P.D.U. Medical College and Hospital, Rajkot, Gujarat 360001 India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):299-306. doi: 10.1007/s12070-020-02068-5. Epub 2020 Aug 25.
To address the management of complications after temporal bone fractures and the outcomes. A prospective clinical study of 100 patients from the Department of Trauma (Surgery + E.N.T.), P.D.U. Medical College, Rajkot between the time period of 2017-2019. Among 100 patients, 79 were males and 21 were females. The most affected age group was 16-45 years (72). The longitudinal fracture (90) is the most common type of fracture, in which non-petrous type is the most prevalent (88) as low impact injuries are more common. The most common presentations of temporal bone fracture are ear bleed (59) and decreased hearing (59), mostly over the side of trauma. The most common clinical finding is hearing impairment (59), followed by haemotympanum (20) and facial palsy (15), more common over the side of trauma. Facial palsy had been easily managed conservatively by steroids and physiotherapy in most of the cases. 12 out of 15 patients had good recovery i.e. upto grade I and II by conservative management, 3 had undergone facial nerve decompression, following which 1 had recovered completely, i.e. grade 1; 1 upto grade II while 1 did not show any improvement. Other complications included giddiness (18), trigeminal neuralgia (1) and abducens nerve palsy (1). The temporal bone is more prone to injury and complications following trauma like hearing impairment, cerebrospinal fluid leak and facial palsy resolve either spontaneously or with conservative management. Surgeries must be undertaken only if adequate conservative treatment fails and after proper investigations.
为探讨颞骨骨折后并发症的处理及治疗效果。对2017年至2019年期间在拉杰果德市PDU医学院创伤科(外科+耳鼻喉科)就诊的100例患者进行了一项前瞻性临床研究。100例患者中,男性79例,女性21例。受影响最严重的年龄组为16 - 45岁(72例)。纵行骨折(90例)是最常见的骨折类型,其中非岩部型最为普遍(88例),因为低冲击力损伤更为常见。颞骨骨折最常见的表现是耳出血(59例)和听力下降(59例),大多发生在受伤侧。最常见的临床发现是听力障碍(59例),其次是鼓室积血(20例)和面神经麻痹(15例),在受伤侧更为常见。在大多数病例中,面神经麻痹通过类固醇和物理治疗很容易得到保守治疗。15例患者中有12例通过保守治疗恢复良好,即达到I级和II级,3例接受了面神经减压术,则1例完全恢复,即1级;1例恢复到II级,而1例没有任何改善。其他并发症包括头晕(18例)、三叉神经痛(1例)和展神经麻痹(1例)。颞骨在创伤后更容易受到损伤并引发并发症,如听力障碍、脑脊液漏和面神经麻痹,这些并发症要么自行缓解,要么通过保守治疗得到解决。只有在充分的保守治疗失败且经过适当检查后,才必须进行手术。