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一项关于颞骨骨折听力损失模式及其恢复情况的前瞻性观察研究。

A Prospective Observational Study on the Pattern of Hearing Loss and Its Recovery in Temporal Bone Fractures.

作者信息

Prasad B K, Jerath Varun, Shukla Shambhavi

机构信息

Present Address: Rama Medical College Hospital & Research Centre, Kanpur, Uttar Pradesh 209217 India.

Present Address: Army Hospital (R&R), New Delhi, 110010 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3686-3695. doi: 10.1007/s12070-023-04036-1. Epub 2023 Jul 17.

Abstract

To study the pattern of hearing loss and its recovery in cases of temporal bone fractures. 95 cases of temporal bone fractures, selected from head injury cases, were examined in Trauma centre or Intensive care unit or in Otorhinolaryngology department in a tertiary care Army Hospital. Hearing loss was assessed by pure tone audiometry. The recovery pattern of hearing loss in each case was studied by further follow up audiometry after 30 days, 60 days and 90 days. Hearing loss was detected in 71 cases. Majority (42%) had mild degree of hearing loss followed by severe (18%). There were equal numbers of sensorineural and conductive hearing loss. Hearing loss was higher in transverse (62%) and oblique (27%) fractures compared to longitudinal (11%). Severe, profound and high frequency hearing loss were more associated with otic capsule violating fractures as compared to otic capsule sparing fractures. Complete recovery to under 25dBHL as seen on day 30, 60 and 90 were 27%, 32% and 59% respectively. Hearing loss, though under reported, is an important complication which often occurs in all types of temporal bone fractures. Conductive hearing loss is as common as sensorineural one. Otic capsule violating fracture is more likely to cause severe and profound hearing loss. Complete recovery is not the rule.

摘要

研究颞骨骨折患者的听力损失模式及其恢复情况。从颅脑损伤病例中选取95例颞骨骨折患者,在一家三级甲等军队医院的创伤中心、重症监护病房或耳鼻咽喉科进行检查。通过纯音听力测定评估听力损失情况。通过在30天、60天和90天后进一步进行随访听力测定,研究每例患者听力损失的恢复模式。71例患者检测出听力损失。大多数(42%)为轻度听力损失,其次为重度(18%)。感音神经性听力损失和传导性听力损失的病例数相等。与纵行骨折(11%)相比,横行骨折(62%)和斜行骨折(27%)的听力损失发生率更高。与未累及听骨链的骨折相比,累及听骨链的骨折更易导致重度、极重度和高频听力损失。在第30天、60天和90天,听力完全恢复至25dBHL以下的患者分别为%、32%和59%。听力损失虽报道较少,但却是各类颞骨骨折常出现的重要并发症。传导性听力损失与感音神经性听力损失同样常见。累及听骨链的骨折更易导致重度和极重度听力损失。听力并非都能完全恢复。

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本文引用的文献

1
Otological Assessment in Head Injury Patients: A Prospective Study and Review of Literature.颅脑损伤患者的耳科评估:一项前瞻性研究及文献综述
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):658-667. doi: 10.1007/s12070-021-02456-5. Epub 2021 Mar 2.
2
A Study of Otological Manifestations of Temporal Bone Fractures.颞骨骨折的耳科表现研究
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):351-359. doi: 10.1007/s12070-020-02111-5. Epub 2020 Sep 11.
4
Hearing and Mortality Outcomes following Temporal Bone Fractures.颞骨骨折后的听力及死亡率结果
Craniomaxillofac Trauma Reconstr. 2017 Dec;10(4):281-285. doi: 10.1055/s-0037-1601885. Epub 2017 Apr 19.
7
A study of temporal bone fractures.颞骨骨折的一项研究。
Indian J Otolaryngol Head Neck Surg. 2008 Sep;60(3):223-6. doi: 10.1007/s12070-008-0082-1. Epub 2008 Oct 22.
8
Temporal bone fracture: evaluation and management in the modern era.颞骨骨折:现代的评估与管理
Otolaryngol Clin North Am. 2008 Jun;41(3):597-618, x. doi: 10.1016/j.otc.2008.01.006.
10

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