Clinical features and radiological evaluation of otic capsule sparing temporal bone fractures

2017 ◽  
Vol 131 (3) ◽  
pp. 209-214 ◽  
Author(s):  
S W Song ◽  
B C Jun ◽  
H Kim
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Bone Fractures ◽  
Regional Analysis ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Otic Capsule ◽  
Type Iv ◽  
Temporal Bones

AbstractObjective:To evaluate the clinical and radiological aspects of otic capsule sparing temporal bone fractures.Methods:Using medical records, 188 temporal bones of 173 patients with otic capsule sparing temporal bone fractures were evaluated. Otoscopic findings and symptoms, facial paralysis, and hearing loss were assessed.Results:Using regional analysis, 7 fractures were classified as type I, 85 as type II, 169 as type III and 114 as type IV. Fourteen of the 17 facial paralysis cases improved to House–Brackmann grade II or lower at an average of 57.6 days after the initial evaluation. Thirty-one patients underwent initial and follow-up pure tone audiometry examinations. The air–bone gap closed significantly from 27.2 dB at an average of 21.8 days post-trauma to 19.6 dB at an average of 79.9 days post-trauma, without the need for surgical intervention.Conclusion:Initial conservative treatment for facial paralysis or conductive hearing loss is possible in otic capsule sparing fracture cases after careful evaluation of the patient.

scholarly journals Bilateral temporal bone fractures: a case report

2017 ◽  
Vol 4 (1) ◽  
pp. 271
Author(s):  
Kiran Natarajan ◽  
Koka Madhav ◽  
A. V. Saraswathi ◽  
Mohan Kameswaran
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Facial Nerve ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Bone Fractures ◽  
Clinical Manifestations ◽  
Csf Leak ◽  
The Right ◽  
Temporal Bones

<p>Bilateral temporal bone fractures are rare; accounting for 9% to 20% of cases of temporal bone fractures. Clinical manifestations include hearing loss, facial paralysis, CSF otorhinorrhea and dizziness. This is a case report of a patient who presented with bilateral temporal bone fractures. This is a report of a 23-yr-old male who sustained bilateral temporal bone fractures and presented 18 days later with complaints of watery discharge from left ear and nose, bilateral profound hearing loss and facial weakness on the right side. Pure tone audiometry revealed bilateral profound sensori-neural hearing loss. CT temporal bones &amp; MRI scans of brain were done to assess the extent of injuries. The patient underwent left CSF otorrhea repair, as the CSF leak was active and not responding to conservative management. One week later, the patient underwent right facial nerve decompression. The patient could not afford a cochlear implant (CI) in the right ear at the same sitting, however, implantation was advised as soon as possible because of the risk of cochlear ossification. The transcochlear approach was used to seal the CSF leak from the oval and round windows on the left side. The facial nerve was decompressed on the right side. The House-Brackmann grade improved from Grade V to grade III at last follow-up. Patients with bilateral temporal bone fractures require prompt assessment and management to decrease the risk of complications such as meningitis, permanent facial paralysis or hearing loss. </p>

scholarly journals Hearing loss following temporal bone fractures- a study on classification of fractures and the prognosis

2017 ◽  
Vol 3 (2) ◽  
pp. 390
Author(s):  
Nagaraj Maradi ◽  
Somanath B. M.
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Tertiary Care ◽  
Classification Systems ◽  
Otic Capsule ◽  
Care Hospital ◽  
Temporal Bone Fracture ◽  
Traditional System

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Temporal bone fractures are traditionally classified as transverse, longitudinal or mixed fractures depending on their relationship to the petrous pyramid. However recent studies show that classifying temporal bone fractures as otic capsule sparing (OCS) and otic capsule violating (OCV) types has more relevance with the prognosis of hearing loss and other associated complications. To assess the predictive value of two different types of temporal bone fracture classification systems with respect to hearing loss and its type.</span></p><p class="abstract"><strong>Methods:</strong> This prospective study was done on patients attending a tertiary care hospital in the study period of one year. Temporal bone fracture patients satisfying inclusion and exclusion criteria were clinically and audiologically evaluated. All patients with temporal bone fractures were categorized into two groups - Longitudinal/ Transverse (old) and OCS / OCV (new). <span lang="EN-IN">Hearing loss was evaluated audiologically on multiple intervals- initially following the injury once the patient is stable, later after a gap of 1 month and 3 months following the injury. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">During the study period, 45 patients presenting with temporal bone fractures who satisfied the selection criteria were evaluated. The correlation was statistically significant for new classification system (<em>P</em>- 0.000) with respect to severity and prognosis of hearing loss which was not the case with the old system (<em>P</em>- 0.450). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We found that classifying temporal bone fractures into OCV and OCS correlates well with the severity of the hearing loss, the prognosis of the patient and the residual hearing disability when compared to the traditional system.</span></p>

scholarly journals Hearing and Mortality Outcomes following Temporal Bone Fractures

2017 ◽  
Vol 10 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Adam Honeybrook ◽  
Aniruddha Patki ◽  
Nikita Chapurin ◽  
Charles Woodard
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Conductive Hearing Loss ◽  
Bone Fractures ◽  
Ossicular Chain ◽  
Otic Capsule ◽  
Temporal Bone Fracture ◽  
Longitudinal Fractures ◽  
Conductive Hearing

The aim of this article is to determine hearing and mortality outcomes following temporal bone fractures. Retrospective chart review was performed of 152 patients diagnosed with a temporal bone fracture presenting to the emergency room at a tertiary care referral center over a 10-year period. Utilizing Patients’ previously obtained temporal bone computed tomographic scans and audiograms, fractures were classified based on several classification schemes. Correlations between fracture patterns, mortality, and hearing outcomes were analyzed using χ2 tests. Ossicular chain disruption was seen in 11.8% of patients, and otic capsule violation was seen in 5.9%; 22.7% of patients presented for audiologic follow-up. Seventeen patients with conductive hearing loss had air–bone gaps of 26 ± 7.5 dB (500 Hz), 27 ± 6.8 dB (1,000 Hz), 18 ± 6.2 dB (2,000 Hz), and 32 ± 7.7 dB (4,000 Hz). Two cases of profound sensorineural hearing loss were associated with otic capsule violation. No fracture classification scheme was predictive of hearing loss, although longitudinal fractures were statistically associated with ossicular chain disruption ( p < 0.01). Temporal bone fractures in patients older than 60 years carried a relative risk of death of 3.15 compared with those younger than 60 years. The average magnitude of conductive hearing loss resulting from temporal bone fracture ranged from 18 to 32 dB in this cohort. Classification of fracture type was not predictive of hearing loss, despite the statistical association between ossicular chain disruption and longitudinal fractures. This finding may be due to the low follow-up rates of this patient population. Physicians should make a concerted effort to ensure that audiological monitoring is executed to prevent and manage long-term hearing impairment.

scholarly journals Hearing gain after tympanoplasty: a prospective study

2020 ◽  
Vol 6 (6) ◽  
pp. 1096
Author(s):  
Manzoor Ahmad Latoo ◽  
Romesh Bhat ◽  
Aleena Shafi Jallu
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Type Ii ◽  
Canal Wall ◽  
Type Iv ◽  
Canal Wall Down ◽  
Type I Tympanoplasty ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> The aim of the present study was to determine hearing improvement in different types of tympanoplasties by comparing mean preoperative air bone (AB) gap with mean postoperative AB gap. The study focused on reconstruction of tympanic membrane and ossicular apparatus by tympanoplasty alone or tympanoplasty with mastoid surgeries (canal wall up or canal wall down).</p><p class="abstract"><strong>Methods:</strong> 60 patients of either sex having chronic otitis media with conductive hearing loss of &gt;20 dB were included in the study. Each patient had to undergo preoperative and postoperative pure tone audiometry to calculate average AB gap. Patients underwent tympanoplasty, with or without mastoid exploration depending on the disease status. Pure tone audiometry (PTA) was done at 3 months and 6 months and compared with pre-operative PTA.  </p><p class="abstract"><strong>Results:</strong> Preoperatively PTA showed 29 (48.33%) patients had mild degree of hearing loss, followed by moderate degree of hearing loss in 18 (30.0%) patients. 10 (16.67%) patients had minimal hearing loss and moderately severe hearing loss was seen in 3 (5%) patients. Tympanoplasty alone was done in 52 patients (86.67%). Tympanoplasty with canal wall up mastoidectomy was done in 6 (10%) and tympanoplasty with canal wall down mastoidectomy was done in 2 (3.33%) patients. Type I tympanoplasty was performed in 37 (61.6%) patients, type-III tympanoplasty was the type of surgery in 15 (25.0%) patients. Type II and type IV tympanoplasties were performed in 4 (6.7%) patients each separately.</p><p class="abstract"><strong>Conclusions:</strong> Hearing gain is better in type I tympanoplasty than in tympanoplasty type II, type III and type IV with or without mastoid surgeries.</p><strong></strong>

Comparison of the application of artificial ossicles and autologous ossicles in the reconstruction of a damaged ossicular chain

2018 ◽  
Vol 132 (10) ◽  
pp. 885-890
Author(s):  
L Zhao ◽  
J Li ◽  
S Gong
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Pure Tone ◽  
Bone Fractures ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Facial Nerve Paralysis ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis ◽  
Ossicular Reconstruction

AbstractObjectiveTo evaluate the therapeutic effect that the titanium partial ossicular reconstruction prosthesis and autologous ossicles have on hearing loss after reconstruction of a damaged ossicular chain.MethodsForty-two medical records of treatments carried out from 2013 to 2015 for ossicular chain damage with facial nerve paralysis due to temporal bone fractures were reviewed. The study assessed: causes of damage, pre-operative pure tone audiometry findings, types of intra-operative ossicular chain damage, intra-operative ossicular chain repair methods (titanium partial ossicular reconstruction prosthesis or autologous ossicles) and post-operative pure tone audiometry results.ResultsThe titanium partial ossicular reconstruction prosthesis was used in 26 cases; the average air–bone gap was 32.3 ± 5.3 dB pre-operatively and 12.8 ± 5.3 dB post-operatively. Autologous ossicles were used in 16 cases; the average air–bone gap was 33.4 ± 4.5 dB pre-operatively and 17.8 ± 7.8 dB post-operatively.ConclusionOssicular chain reconstruction is an effective way of improving hearing in patients with ossicular chain damage. The results suggest that repair with either the titanium partial ossicular reconstruction prosthesis or autologous ossicles can improve hearing following ossicular chain injury with facial nerve paralysis caused by a temporal bone fracture.

Management of Temporal Bone Fractures

Neurotrauma ◽  
2019 ◽  
pp. 103-112
Author(s):  
Hongzhao Ji ◽  
Brandon Isaacson
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Bone Fractures ◽  
Surgical Decompression ◽  
Vascular Injuries ◽  
Surgical Exploration ◽  
Mixed Hearing Loss ◽  
Csf Leakage ◽  
Spontaneous Improvement ◽  
Fluid Leak

Temporal bone fractures can present with a variety of symptoms and physical exam findings. Facial paralysis, hearing loss, spinal fluid leak, vestibular dysfunction, and vascular injuries are all potential issues that may occur in the setting of skull base trauma. The indications and interpretation of facial nerve electrophysiology studies with respect to the need for surgical decompression or repair are reviewed. Injuries to the middle and inner ear may result in conductive, mixed, or pure sensorineural hearing loss depending on the location of the fracture. Surgical repair of conductive or mixed hearing loss should be delayed because spontaneous improvement often occurs. CSF leakage presents with clear or serosanguineous aural discharge and typically resolves with conservative measures. Occasionally spinal fluids leaks require lumbar subarachnoid drainage or surgical exploration and repair. Evaluation and management of other issues arising as a result of temporal bone trauma will also be reviewed.

Temporal Bone Fractures: Otic Capsule Sparing versus Otic Capsule Violating Clinical and Radiographic Considerations

1999 ◽  
Vol 47 (6) ◽  
pp. 1079 ◽  
Author(s):  
Ravinder Dahiya ◽  
Jeanne D. Keller ◽  
N. Scott Litofsky ◽  
Paul E. Bankey ◽  
Lawrence J. Bonassar ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Bone Fractures ◽  
Otic Capsule

A Systematic Review of Cochlear Implantation in Temporal Bone Fractures and the Significance of Otic Capsule Involvement

2020 ◽  
Vol 41 (10) ◽  
pp. 1309-1315
Author(s):  
Brandon Cowan ◽  
Sandra Oska ◽  
Khashayar Arianpour ◽  
Peter F. Svider ◽  
Dennis Bojrab ◽  
...  
Keyword(s):  
Systematic Review ◽  
Temporal Bone ◽  
Cochlear Implantation ◽  
Bone Fractures ◽  
Otic Capsule

Epidemic typhus fever and hearing loss: a histological study

1993 ◽  
Vol 107 (4) ◽  
pp. 275-283 ◽  
Author(s):  
I. Friedmann ◽  
A. Frohlich ◽  
A. Wright
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Mononuclear Cells ◽  
Histological Study ◽  
Eastern Asia ◽  
Nerve Fibres ◽  
Epidemic Typhus ◽  
Temporal Bones ◽  
Typhus Fever ◽  
Unique Study

Hearing loss as a frequent complication of louse–bome epidemic typhus fever has been well documented in the reports of ENT specialists serving in both the Allied and the German armies in the last war. The present paper describes the characteristic histopathological features as noted in sections of the temporal bones from five British soldiers who died in 1944 of typhus fever during the last war in Eastern Asia. The VHIth nerve showed multiple ‘typhus nodules’ and there was extensive interstitial neuritis of the VHIth nerve and demyelination of the nerve fibres. There were also widely scattered aggregations of mononuclear cells in the inner ear.This unique study was based on the Hallpike collection of temporal bone sections.

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