Clinical-radiological Correlation in Temporal Bone Fractures.

Acta Otorrinolaringol Esp (Engl Ed)

Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain; Centro de Investigación Biomédica en Red para Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.

Published: October 2021

AI Article Synopsis

  • The study focuses on the diagnosis of temporal bone fractures (TBF) using CT imaging, classifying them into longitudinal, transverse, and mixed types, and examining recent classifications for better clinical prediction.
  • Researchers analyzed 110 TBF cases, finding 52 transverse, 34 longitudinal, and 19 mixed fractures, with specific types linked to different hearing loss patterns and complications.
  • The results indicate that while traditional classifications are reliable, understanding the fractures' connection to the otic capsule and mastoid pneumatization is crucial, as better pneumatization doesn't reduce fracture severity or complications.

Article Abstract

Introduction: The diagnosis of temporal bone fractures (TBF) is based on radiological imaging. The most widely used classification divides fractures into longitudinal, transverse, and mixed. In recent years, other classifications have emerged to better predict clinical manifestations.

Objectives: To review computed tomography (CT) images of TBF, define their radiological pattern, and study the concordance of the observed findings with those described in the radiological report. To analyse the association between fracture types and clinical findings. To study the impact of mastoid pneumatization on fracture characteristics.

Methods: Retrospective study of 110 TBF diagnosed with CT between January 2016 and May 2019.

Results: Fifty-two transverse (47%), 34 longitudinal (30%), and 19 mixed fractures (17%) were identified with good interobserver agreement (k = .637). Longitudinal fractures were associated with conductive hearing loss (P < .001) and transverse fractures with sensorineural hearing loss (P = .005). Of the fractures, 8.2% showed involvement of the otic capsule, and were associated with sensorineural hearing loss (P < .001), facial paralysis (P = .019) and vertigo (P= .035). Fractures were more frequent in cases of greater pneumatization, and the involvement of the otic capsule in cases of very good pneumatization (P = .024).

Conclusions: The traditional classification of TBF is reproducible. Its association with clinical findings improves when the involvement of the otic capsule is also analysed. Mastoid pneumatization is not a protective factor for TBF or for involvement of the otic capsule.

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http://dx.doi.org/10.1016/j.otoeng.2020.09.003DOI Listing

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