HSC Section 8_April 2017
Reprinted by permission of Int J Pediatr Otorhinolaryngol. 2016; 84:106-109.
International
Journal
of Pediatric Otorhinolaryngology 84
(2016)
106–109
Contents
lists
available
at ScienceDirect
International
Journal
of Pediatric Otorhinolaryngology
jour nal
homepage:
www.elsevier .com/locat e/ijpo r l
Pediatric
temporal
bone
fractures:
A
case
series
S. Waissbluth a , L.H.P. Nguyen a , * a Department
Ywakim a ,
Al Qassabi b ,
Torabi c ,
Carpineta b ,
J. Manoukian a ,
R.
B.
B.
L.
of Otolaryngology-Head Radiology, Montreal Pediatrics, University of of
and Neck
Surgery, Montreal
Children’s Hospital, McGill University, Montreal, Quebec,
Canada
b Department c Department
Children’s Hospital, McGill University, Montreal, Quebec,
Canada
of
British
Columbia,
Vancouver,
British
Columbia,
Canada
A
R
T
I
C
L
E
I
N
F
O
A
B
S
T
R
A
C
T
Article
history:
Temporal bone
fractures are relatively common findings
in patients with head trauma. The aim
Objectives:
Received Received Accepted Available Keywords: Temporal Skull Fracture Pediatric
19
January
2016
this
study was
to
evaluate
the
characteristics of
temporal bone
fractures
in
the pediatric population.
of
in
revised
form
26
February
2016
Retrospective
case
series.
Tertiary
care
pediatric
academic medical
center.
design:
Study
26
February
2016
The medical
records of patients aged 18 years or
less diagnosed with a
temporal bone
fracture Patient Imaging
Methods:
online
10 March
2016
the
Montreal
Children’s
Hospital
from
January
2000
to
August
2014
were
reviewed. analyzed.
at
clinical
presentation, mechanism
of
injury
and
complications were
demographics,
and
audiograms were
also
evaluated.
studies Results: with a
Out of 323 patients presenting to
the emergency department with a skull
fracture, 61 presented
temporal bone
fracture. Of
these, 5 presented with bilateral
fractures. 47 patients had associated
fractures, and 3 patients deceased. We observed a male to
female
ratio of 2.8:1, and
the average age was
accidents were
the primary mechanism of
injury
(53%), signs
followed by
falls
(21%)
9.5 years. Motor vehicle
bicycle
or
skateboard
accidents
(10%).
The most
common
presenting
included
hemotympa-
and
decreased
or
loss
of
consciousness, tomography
facial
swelling
and
nausea
and
vomiting.
8
patients
had near
otic the
num,
on
computed
scans,
and
30
patients hearing
had
documented
hearing
loss
involvement
of
accident
with
a
majority
being
conductive
loss.
17
patients
underwent
surgical
time
of
intracranial
pressure.
management Conclusion: In
children,
fractures common
of
the
temporal
bone
were
most
often
caused
by
motor
vehicle
and
falls.
It
is
for
these
patients
to
have
associated
fractures.
accidents
2016
Elsevier
Ireland
Ltd.
All
rights
reserved.
1. Introduction
and balance;
the
cochlea
and
vestibule
[3] . As
such,
trauma
to
this
lead to a variety of clinical presentations
including tympanic
intricate area can
bone
fractures
are
of
special
interest
for
clinicians
loss,
hemotympanum,
loss
of
consciousness,
hearing
Temporal
that
they
can
translate
into
an
array
of
complications,
and
injury, cerebrospinal
given
membrane perforation, otorrhagia, facial nerve
they
usually
arise
from
high
impact
trauma
[1] .
(CSF)
leakage,
ecchymosis
of
the
post-auricular
skin
(Battle
that
fluid sign)
temporal bones
are are
complex
structures
forming part of
the
and periorbital
area
(raccoon
sign)
[4–6] .
The
skull base.
They
each made up of five parts:
the
styloid,
A limited amount of articles
regarding
temporal bone
fractures
lateral
squamous,
mastoid
and
petrous
portions
[2] .
The part
children
are
available evaluate
in
the
current
literature.
The
aim
of
this
tympanic, temporal
in
bones
articulate with
other
cranial
bones
and
form
was
to
the
characteristics
of
temporal
bone
study
the middle
and
posterior
fossae.
Important
neural nerve,
and
vascular
in
patients
aged
18
years
or
less
in
a
pediatric
tertiary
of
fractures
components nerve, internal carotidartery and jugular vein, have part of their trajectories though this bone. They also contain the sensory organs of hearing such as the vestibulocochlear facial
hospital
setting.
care
2. Methods
Ethical
approval
2.1.
* Corresponding
author
at:
Montreal
Children’s
Hospital,
1001
Boul
De´carie,
approval
for
this
study was obtained
from
the pediatric
Ethical
Room
A02.3015, Montre´al, QC,
Canada H4A
3J1.
Tel.:
+1
514
412
4040;
ethics
committee 11-731-PED.
at the McGill University Health Centre.
research
+1
514
412
4342.
fax:
number
Study
lily.hp.nguyen@gmail.com
(L.H.P. Nguyen).
address:
http://dx.doi.org/10.1016/j.ijporl.2016.02.034 0165-5876/ 2016 Elsevier Ireland Ltd. All
rights
reserved.
213
Made with FlippingBook