Council of Forensic Medicine, Gümüşhane Forensic Medicine Branch Office, Gümüşhane-Türkiye.
Council of Forensic Medicine 2nd Specialization Board İstanbul, İstanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Jun;30(6):444-454. doi: 10.14744/tjtes.2024.63099.
Over 5% of the global population (430 million people) require rehabilitation for hearing loss. Individuals with hearing impairments face significant challenges in business, daily life, and social participation. Hearing loss (HL) and other permanent physical and sensory disabilities escalate dramatically in cases with brain damage and temporal bone trauma associated with head injuries. This study aims to identify the significant risk factors for hearing loss following head trauma, utilizing current data, and discuss the findings in the context of the literature. This could contribute to the development of standard approaches for assessing such cases.
This retrospective study reviewed files and reports from individuals assessed for hearing loss at Dokuz Eylül University Faculty of Medicine, Department of Forensic Medicine. The study included cases that applied at least 12 months post-trauma, between January 1, 2016, and December 31, 2022, after their recovery process was completed. Sociodemographic data, types of temporal bone fractures, initial otoscopic examination findings, presence or absence of intracranial injury, type of hearing loss, and audiometry test results for air and bone conduction pure tone threshold averages were evaluated. Data analysis was conducted using SPSS 26.0 (Statistical Package for the Social Sciences).
Out of 244 cases, 177 (72.5%) were male and 67 (27.5%) were female. It was observed that the majority of trauma cases occurred in the 19-40 age group (49.2%; n=120). In the initial otoscopic examinations post-trauma, otorrhagia/otorrhea was the most common finding, both as an isolated symptom (n=59, 24.2%) and when accompanied by other symptoms. No temporal bone fractures were detected in 43 cases (17.6%). Longitudinal fractures were found in 141 cases (57.8%), transverse fractures in 48 (19.7%), and mixed-type fractures in 12 (4.9%). The statistical difference in air conduction and bone conduction pure tone threshold averages between groups with and without intracranial injury was significant (p<0.001).
Post-traumatic examinations should employ a multidisciplinary approach, adhering to standard medical improvement and assessment timelines. It is essential to verify whether each patient's medical improvement process has reached its maximum potential. We believe that adhering to these recommendations and utilizing standardized classifications for hearing loss will prevent the loss of rights.
全球超过 5%的人口（4.3 亿人）需要进行听力损失康复治疗。听力受损的个体在商业、日常生活和社会参与方面面临重大挑战。听力损失（HL）和其他永久性的身体和感官残疾在与头部损伤相关的脑损伤和颞骨创伤的情况下会急剧增加。本研究旨在利用现有数据确定头部创伤后听力损失的显著风险因素，并结合文献讨论研究结果。这有助于制定评估此类病例的标准方法。
这是一项回顾性研究，对在宰牲节大学医学院法医学系评估听力损失的个人的档案和报告进行了审查。该研究包括在创伤后至少 12 个月（2016 年 1 月 1 日至 2022 年 12 月 31 日）申请的病例，且在康复过程完成后。评估了社会人口统计学数据、颞骨骨折类型、初始耳镜检查结果、是否存在颅内损伤、听力损失类型以及空气和骨导纯音阈值平均的听力图检查结果。使用 SPSS 26.0（社会科学统计软件包）进行数据分析。
在 244 例中，177 例（72.5%）为男性，67 例（27.5%）为女性。观察到大多数创伤病例发生在 19-40 岁年龄组（49.2%；n=120）。在创伤后的初始耳镜检查中，耳漏/耳溢是最常见的发现，既可以是孤立的症状（n=59，24.2%），也可以与其他症状一起出现。在 43 例（17.6%）中未发现颞骨骨折。在 141 例（57.8%）中发现纵向骨折，在 48 例（19.7%）中发现横向骨折，在 12 例（4.9%）中发现混合类型骨折。有颅内损伤组和无颅内损伤组的气导和骨导纯音阈值平均值的统计学差异有显著意义（p<0.001）。
创伤后检查应采用多学科方法，遵循标准的医疗改善和评估时间线。必须验证每位患者的医疗改善过程是否已达到最大潜力。我们相信，遵循这些建议并对听力损失使用标准化分类将防止权利丧失。
