Skip to main content
Log in

A Prospective Study on Temporal Bone Involvement in Polytrauma Patients and the Effect of Early Diagnosis on Hearing Loss

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

As polytrauma cases are on the rise, a large number of patients presents with temporal bone fractures, which can result in various types of injuries varying from trivial to more serious injuries. Early diagnosis and appropriate management in required in case of serious injuries for a better outcome. The aim of my study is to study the incidence, the different injuries occurring and the effect of early diagnosis on hearing loss. Patients coming to our emergency department with polytrauma are studied and clinically evaluated for any temporal bone injuries. Based on the type of injuries audiological and radiological studies are done. And if required, biochemical tests like CSF analysis will be done. Also hearing assessment will be done as early as possible and appropriate treatment required will be started. The outcome is then assessed and followed up on a regular basis. In our study there were 90 patients with temporal bone fracture out of the 2748 polytrauma cases. The incidence was calculated to be 32 per 1000 cases. 69 patients (76.7%) had longitudinal fracture of temporal bone; 13 patients (14.4%) had transverse fracture; 2 patients (2.2%) had oblique fractures and 6 patients (6.6%) had comminuted fractures. Hearing loss was found to be the most common injury seen in 56 patients (62.2%). Of which 30 (53.5%) had conductive hearing loss (CHL); 9 (16%) had sensorineural hearing loss (SNHL); 17 had mixed hearing loss (MHL). 27 (90%) out of 30 patients with CHL showed improvement in hearing. Out of the 26 patients with SNHL and MHL, 22 patients (84.61%) showed improvement. 5 out of 6 with immediate onset facial palsy and 6 out of 8 with late onset facial palsy showed improvement. The hearing outcome in our study was found to be much better than the previous year which shows that the difference might be due to the early diagnosis and management. In our study hearing improvement was noted in most patients with hearing loss when compared to the previous year, which may have been due to the detection of the injuries at the earliest and managing the same with appropriate treatment modalities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Zayas JO, Feliciano YZ, Hadley CR, Gomez AA, Vidal JA (2011) Temporal bone trauma and the role of multidetector CT in the emergency department. Radiographics 31(6):1741–1755

    Article  Google Scholar 

  2. Cannon CR, Jahrsdoerfer RA (1983) Temporal bone fractures: review of 90 cases. Arch Otolaryngol 109(5):285–288

    Article  CAS  Google Scholar 

  3. Lee D, Honrado C, Har-El G, Goldsmith A (1998) Pediatric temporal bone fractures. Laryngoscope 108(6):816–821

    Article  CAS  Google Scholar 

  4. Johnson F, Semaan MT, Megerian CA (2008) Temporal bone fracture: evaluation and management in the modern era. Otolaryngol Clin North Am 41(3):597–618

    Article  Google Scholar 

  5. Patel A, Groppo E (2010) Management of temporal bone trauma. Craniomaxillofac Trauma Reconstr 3(2):105–113

    Article  Google Scholar 

  6. Leung MA, Flaherty A, Zhang JA, Hara J, Barber W, Burgess L (2016) Sudden sensorineural hearing loss: primary care update. Hawaii J Med Public Health 75(6):172–174

    PubMed  PubMed Central  Google Scholar 

  7. Momose KJ, Davis KR, Rhea JT (1983) Hearing loss in skull fractures. AJNR Am J Neuroradiol 4(3):781–785

    CAS  PubMed  Google Scholar 

  8. Yalçıner G, Kutluhan A, Bozdemir K, Cetin H, Tarlak B, Bilgen AS (2012) Temporal bone fractures: evaluation of 77 patients and a management algorithm. Ulus Travma Acil Cerrahi Derg 18(5):424–428

    Article  Google Scholar 

  9. Amin Z, Sayuti R, Kahairi A, Islah W, Ahmad R (2008) Head injury with temporal bone fracture: one year review of case incidence, causes, clinical features and outcome. Med J Malaysia 63(5):373–376

    CAS  PubMed  Google Scholar 

  10. Ishman SL, Friedland DR (2004) Temporal bone fractures: traditional classification and clinical relevance. Laryngoscope 114(10):1734–1741

    Article  Google Scholar 

  11. Katzen JT, Jarrahy R, Eby JB, Mathiasen RA, Margulies DR, Shahinian HK (2003) Craniofacial and skull base trauma. J Trauma 54(5):1026–1034

    Article  Google Scholar 

Download references

Funding

Nil.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Ramesh Kumar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Padmakumar, V., Ramesh Kumar, E. & Ramakrishnan, V.R. A Prospective Study on Temporal Bone Involvement in Polytrauma Patients and the Effect of Early Diagnosis on Hearing Loss. Indian J Otolaryngol Head Neck Surg 72, 30–35 (2020). https://doi.org/10.1007/s12070-019-01723-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-019-01723-w

Keywords

Navigation