Abstract
Temporal bone fractures following blunt force trauma can result in significant morbidity including complete hearing loss. We present the case of a 15 year-old male who suffered traumatic bilateral transverse temporal bone fractures through both cochleae, resulting in profound bilateral hearing loss. Having met criteria for cochlear implantation, he was successfully managed with expedited, simultaneous bilateral cochlear implantation preceded immediately by evoked auditory brainstem response testing. The auditory brainstem response demonstrated weak wave V activity with high-level stimulation, and placement of the cochlear implants albeit it challenging secondary to early ossification of the cochlea, was successfully performed 5 weeks post-trauma. This case underscores the importance or early diagnosis and expedited implantation following otic capsule fractures to optimize chances for meaningful hearing rehabilitation prior to ossification of inner ear structures.
Highlights
Bilateral temporal bone fractures are relatively rare in trauma due to the significant degree of force required to generate bilateral fracture patterns
There has been a trend towards bilateral implantation in all patients who qualify for cochlear implantation (CI) owning to the improved sound localization and hearing in background noise
We present the case of a 15 year-old male who suffered bilateral transverse otic capsule violating temporal bone fractures with expedited, simultaneous bilateral CI
Summary
Bilateral temporal bone fractures are relatively rare in trauma due to the significant degree of force required to generate bilateral fracture patterns These patients may suffer significant audiovestibular dysfunction, in transverse fractures that involve the otic capsule. The management of profound traumatic sensorineural hearing loss (SNHL) has been well described in the literature with the use of cochlear implantation (CI; Chung et al.; Greenberg et al.; Medina et al.; Serin et al.) [1,2,3,4] Outcomes with this approach have been promising in recent case series with the majority of patients achieving elevated sentence scores (Greenberg et al [2]). We present the case of a 15 year-old male who suffered bilateral transverse otic capsule violating temporal bone fractures with expedited, simultaneous bilateral CI
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