Clinical Features of Temporal Bone Fracture

Abstract

Temporal bone fractures occur in patients with head trauma, and the clinical features varies with the type and severity of fracture.

We studied 55 patients (59 ears) who visited our hospital and were confirmed to have a temporal bone fracture by computerized tomography between August 2003 and March 2014. We evaluated the cause of the injury, type of fracture, head injury, hearing loss, injury to the ossicles, presence of traumatic tympanic membrane perforation, hemotympanum, vertigo, cerebrospinal fluid otorrhea and facial nerve palsy. Falling was the most common cause of injury. Head injuries were more common in mixed-type fractures than in longitudinal or transverse type fractures alone. Conductive hearing loss due only to hemotympanum improved, but most cases with injury to the ossicles or tympanic membrane perforation did not improve. The incidence of traumatic facial nerve palsy was 23.7%. Immediate-onset paralysis was usually due to mixed-type fracture, whereas late-onset paralysis was usually caused by longitudinal fracture. The cure rate for facial nerve palsy was 100% for late-onset paralysis and 0% for immediate-onset paralysis. Early surgical treatment was not needed for cases of late-onset paralysis, but for immediate-onset cases we should consider surgery as soon as possible.