Department of Otolaryngology, Hannover Medical School, Hannover, Germany.
Cluster of Excellence, Hearing4all, Hannover Medical School, Hannover, Germany.
Cochlear Implants Int. 2023 Jul;24(4):195-204. doi: 10.1080/14670100.2022.2148351. Epub 2023 Jan 8.
Temporal bone fracture can cause posttraumatic deafness. Sequelae like ossification or obliteration of the cochlea can impact the outcome of cochlear implantation. This study highlights the effect of localisation of the fracture to morphologic, electric and functional criteria.
The study group consists of patients suffering from hearing loss caused by temporal bone fracture ( = 61 ears). Patients were divided into otic capsule sparing (OCS) and otic capsule involving (OCI) fractures. The OCI group was additionally divided into subgroups with or without signs of ossification inside the cochlea. Postoperative imaging, hearing tests and electrode impedances were analysed.
The results of postoperative hearing rehabilitation showed lower speech understanding scores for the OCI group, especially for the ossification group. OCI fractures with signs of ossification showed increased impedances. Patients in the OCI group suffered more frequently from facial nerve stimulation (FNS). FNS was most frequently observed within the ossification group.
Cochlear implantation in patients with temporal bone fracture is adequate therapy for the treatment of fracture-induced deafness. In long-term observation, these patients show comparable results with regular cochlear implant (CI) patients. Implantation should be performed as soon as possible after hearing loss, before obstructing obliteration or ossification of the cochlea start.
颞骨骨折可导致外伤性耳聋。耳蜗的骨化或闭塞等后遗症会影响耳蜗植入的效果。本研究强调了骨折定位对形态、电和功能标准的影响。
研究组包括因颞骨骨折导致听力损失的患者（=61 耳）。患者分为耳囊保留（OCS）和耳囊受累（OCI）骨折。OCI 组还根据耳蜗内是否有骨化迹象进一步分为亚组。分析术后影像学、听力测试和电极阻抗。
术后听力康复结果显示，OCI 组，尤其是骨化组的言语理解评分较低。有骨化迹象的 OCI 骨折显示出更高的阻抗。OCI 组的患者更频繁地出现面神经刺激（FNS）。FNS 最常发生在骨化组。
对于因骨折导致的耳聋，颞骨骨折患者的耳蜗植入是一种足够的治疗方法。在长期观察中，这些患者与常规耳蜗植入（CI）患者的结果相当。植入应在听力损失后尽快进行，以防止耳蜗阻塞、闭塞或骨化。
