HSC Section 8_April 2017

S. Waissbluth

et al.

/ International

Journal

of Pediatric Otorhinolaryngology 84

(2016)

106–109

40

35

30

25

20

15

Number of patients

10

5

0

Fig.

2.

Pediatric

temporal

bone

fractures:

clinical

presentations.

ears were

evaluated

for hearing

impairment:

70

ears

showed

106

3.3.

Associated

fractures

loss, 29 were presented with

consistent with a

conductive hearing

loss and

no hearing

fractures

were

observed

to

be

associated

with

5

a

sensorineural

hearing

loss the

(SNHL)

(CHL),

Multiple

bone

fractures

in

this

study

group.

The most

commonly

Follow-up was

not

consistent.

Of

information

temporal

2 were mixed.

were

parietal

and

sphenoid

bone

fractures.

Other

that

failed

the otoacoustic emissions

initially,

encountered

available, 2 patients

included

frontal, mandible, maxillary,

nasal

bones

and

at

1

week,

and not

3

months

follow

up.

One

patient

with

fractures

passed

facial

bones.

Eight

patients

also

presented

with

SNHL

did

exhibit

any

change

at

2 week

follow

up.

unspecified

profound

suture

diastasis

(see

Fig.

3 ).

(3 CHL, 2

SNHL)

and one with moderate CHL

lambdoid

5 patients with mild

their CHL One

hearing

at

1–2 months

follow

up.

2

patients with

recovered moderate

presented

with mild

CHL

at

1

week,

and

1

year

Complications

and

associated

injuries

3.4.

up.

patient with mild

CHL

remained with

the

same

follow

included

facial three

nerve

injury,

hearing

loss

and

at

3 months

follow

up.

diagnosis

Complications

injuries.

Only

patients

presented

with

facial

computed

tomography

scanning

of

these

patients,

intracranial asymmetry documented

Following

on

physical

examination, with

one

patient

having

a

intracranial

complications

were

observed,

of

which

various

transient

facial

nerve

paresis.

was

the

most

common

as

evidenced

in

pneumocephalus

loss as a clinical

symptom,

patients.

Parenchymal

contusion

and

intracranial

hemorrhag-

While 12 patients described hearing

23

testing

performed

shortly

following

the

incident

demon-

also

frequently

observed.

Seven patients

presented with

hearing strated

ing were

that

30

patients

actually

had

hearing

loss

of

which

shift

or

transtentorial

herniation

( Table

3 ).

either midline

presented

with

mild,

10

with

moderate, audiometry

1

with

severe

and

14

profound

hearing

loss with

testing.

The

other

2 with

Temporal

bone

fracture

types

3.5.

failed otoacoustic emissions. Nine patients did not have

3 patients

audiogram

or

otoacoustic

emission

testing.

In

total,

documented

Based on the traditional classification of temporal bone fractures, 35.9% of the fractures were longitudinal, 10.6% were transverse and 53.9% were mixed. Based on the newer classification established by Little et al. [7] , 9 fractures were otic capsule involving.

Parietal Sphenoid Frontal Occipital Others Ethmoid Orbital roof/wall TMJ

2

3

3

Table 3 Computed

tomography

findings

associated with

tem-

7

bone

fractures

in

the

pediatric

population.

poral

7

Finding

#

of

patients

Pneumocephalus

23 22 13 13 12

8

contusion

Parenchymal Subarachnoid

hemorrhage

10

hemorrhage hemorrhage

Subdural Epidural Midline

22

shift

7 7

herniation

Transtentorial

Fig.

3.

Temporal

bone

fractures:

associated

fractures.

215