Abstract
32 year old male presented with right facial palsy following head injury. Clinical evaluation showed hemotympanum on right with moderately severe conductive hearing loss, grade III LMN facial palsy and BPPV. HRCT of temporal bone demonstrated fracture base of skull involving the roof of mastoid with no evidence of bony injury to fallopian canal. Conservative management of head trauma resulted in satisfactory outcome except for conductive hearing loss and faciel palsy. Facial palsy was managed conservatively [physiotherapy and oral steroids] with full recovery of function after 4 weeks. Conductive hearing loss was managed by combined approach tympanaplasty. Preoperutively incudostapedial joint dislocation and fracture anterior crus of stapes were noted. Type II tympanoplasty with horizontal incus repositioning was carried out.
PTA after 6 weeks showed 15-20 dB air-bone gap compared to 50-55dB air-bone gap preoperatively. BPPV recovered spontaneously. This case is reported to highlight:
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Importance of imaging of temporal bone.
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Spontaneous recovery of facial nerve function in neuropraxtc injury.
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Timely and appropriate surgical intervention of ossicular damage following head injury resulting in satisfatctory outcome.
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References
Michael M Paparella, Donald A Shumnck [1980] Otolaryngology Philadelphia W B Saunders company 2nd edition 1658–1675
John B Booth[1997] Scott Brown s Otolaryngology Great Britain Butterworth Heinemann 6th edition 3/7/5 3/7/8
Shomeshwar Singh, Rami J Salib, John Oates [2002] Transverse fracture of stapes suprastructure following minor head injury Journal of Laryngology & Otology 116 457–459
Hough JVD, Stuart WD [1968] Middle ear injury in skull trauma Laryngoscope 78 889–937
List Baxter A B [2000] Traumatic Ossicular disruption American Journal of Roentgenology 174 1296
Robert Mills, Nicola Starritt [2002] Management of incus dislocation by physiological repositioning of the incus Journal of Laryngology & Otology 116 588–592
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Kiran, K.B., Kumar, A.R. & Senthil, K. Otological manifestations in head injury and their management - a case report. Indian J Otolaryngol Head Neck Surg 55, 46–49 (2003). https://doi.org/10.1007/BF02968755
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DOI: https://doi.org/10.1007/BF02968755