Temporal bone trauma effects on auditory anatomical structures in mastoid obliteration
The risk of temporal bone fractures in head trauma is not negligible, as injuries also depend on the resistance and integrity of head structures. The capacity of mastoid cells to absorb part of the impact kinetic energy of the temporal bone is diminished after open cavity mastoidectomy, even if the surgical procedure is followed by mastoid obliteration. The aim of our study was to evaluate the severity of lesions in auditory anatomical structures after a lateral impact on cadaveric temporal bones in which open cavity mastoidectomy followed by mastoid obliteration was performed, compared to cadaveric temporal bones with preserved mastoids.
The study was carried out on 20 cadaveric temporal bones, which were randomly assigned to two groups. In the study group, open cavity mastoidectomy followed by mastoid obliteration with heterologous materials was performed. All temporal bones were impacted laterally under the same conditions. Temporal bone fractures were evaluated by CT scan.
External auditory canal fractures were six times more seen in the study group. Tympanic bone fractures were present in 80% of the samples in the study group and 10% in the control group (p = .005). Middle ear fractures were found in 70% of the samples in the study group and 10% in the control group (p = .02). Otic capsule violating fractures of the temporal bone were present only in the study group.
Mastoid obliteration with heterologous materials after open cavity mastoidectomy increases the risk of fracture, with the involvement of auditory anatomical structures.
KeywordsTemporal bone fracture Mastoidectomy Mastoid obliteration Auditory anatomical structures Cadaveric study
This study was funded by the “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, Internal Grant no. 4944/8/08.03.2016.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest with respect to the authorship and/or publication of this article.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Committee of “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, No. 250/22.02.2011) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
The study was conducted on temporal bone harvested from human cadavers donated to the “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania.
- 8.Dahiya R, Keller JD, Litofsky NS, Bankey PE, Bonassar LJ, Megerian CA (1999) Temporal bone fractures: otic capsule sparing versus otic capsule violating clinical and radiographic considerations. J Trauma 47:1079–1083. https://www.ncbi.nlm.nih.gov/pubmed/10608536
- 13.Uzun C, Kutoglu T (2007) Assessment of visualization of structures in the middle ear via Tos modified canal wall-up mastoidectomy versus classic canal wall-up and canal wall-down mastoidectomies. Int J Pediatr Otorhinolaryngol 71(6):851–856. https://doi.org/10.1016/j.ijporl.2007.02.004 CrossRefGoogle Scholar
- 15.Irving RM, Gray RF, Moffat DA (1994) Bone pâté obliteration or revision mastoidectomy: a five-symptom comparative study. Clin Otolaryngol Allied Sei 19:158–160. https://www.ncbi.nlm.nih.gov/pubmed/8026096
- 16.East CA, Brough MD, Grant HR (1991) Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol 105(6):417–420. https://www.ncbi.nlm.nih.gov/pubmed/?term=East+CA%2C+Brough+MD%2C+Grant+HR.+Mastoid+obliteration+with+the+temporoparietal+fascia+flap.+J+Laryngol+Otol+1991%3B105(6)%3A417-20