Prasad B K, Basu A, Sahu P K, Rai A K
Department of ENT and HNS, Command Hospital (Central Command), Lucknow, Uttar Pradesh 266002 India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):351-359. doi: 10.1007/s12070-020-02111-5. Epub 2020 Sep 11.
The aim of study was to evaluate various otological manifestations of temporal bone fractures and to suggest their management. This prospective observational study was conducted in a tertiary care hospital of Armed Forces over 2.5 years in 57 cases of temporal bone fracture in patients of age group of 12-59 yrs comprising 49 males and 8 females. Radioimaging was done for diagnosing the fracture, mapping its extent and for clinical correlation. Hearing was assessed by tuning forks, free field hearing and pure tone audiogram as per the fitness of patient. Majority of patients were in the age group 20-40 years who had met with road accidents. Important otological features included Battle sign (24.6%), ear canal laceration (53%), tympanic membrane perforation (7%), haemotymanum (40%), ear discharge (66.7%), hearing loss (63%), vertigo (16%), tinnitus (21%), facial paralysis (68%) and cerebrospinal fluid otorrhea (3.5%). Otic capsule sparing fracture was three times more common than violating ones. Facial palsies were treated with oral steroid with complete recovery in 56.41% cases but three required decompression surgery. 4 patients underwent tympanoplasty. Both the cerebrospinal fluid leaks stopped in 2 weeks time. Facial palsy is as common as hearing loss. TM perforation is as rare as CSF leak. Otic capsule violating fracture line is less common. Hearing loss shows recovery in most of the cases. Delayed onset positional vertigo is more common than acute vertigo. Large numbers of immediate onset complete facial palsy do recover from injury without surgery.
本研究的目的是评估颞骨骨折的各种耳科表现并提出其处理方法。这项前瞻性观察性研究在一家军队三级护理医院进行，历时2.5年，纳入了57例年龄在12至59岁之间的颞骨骨折患者，其中男性49例，女性8例。通过影像学检查来诊断骨折、确定其范围并进行临床关联分析。根据患者的身体状况，采用音叉、自由声场听力测试和纯音听力图来评估听力。大多数患者年龄在20至40岁之间，均遭遇了道路交通事故。重要的耳科特征包括Battle征（24.6%）、耳道撕裂（53%）、鼓膜穿孔（7%）、血鼓室（40%）、耳漏（66.7%）、听力损失（63%）、眩晕（16%）、耳鸣（21%）、面瘫（68%）和脑脊液耳漏（3.5%）。未累及听骨链的骨折比累及听骨链的骨折常见三倍。面瘫患者接受口服类固醇治疗，56.41%的患者完全康复，但有3例需要进行减压手术。4例患者接受了鼓室成形术。脑脊液漏在2周内均停止。面瘫与听力损失一样常见。鼓膜穿孔与脑脊液漏一样罕见。累及听骨链的骨折线较少见。大多数病例的听力损失会恢复。迟发性位置性眩晕比急性眩晕更常见。大量即刻发生的完全性面瘫可在无手术的情况下从损伤中恢复。
