Patient-Assessed Outcomes following Temporal Bone Fractures.

Elias Antoniades,Ioannis Patsalas,George Psillas,Konstantinos Polyzoidis

doi:10.3390/diagnostics12020547

Elias Antoniades, Ioannis Patsalas + Show 2 more

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https://doi.org/10.3390/diagnostics12020547

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Abstract

The long-term impact of neurotological symptoms after a temporal bone fracture (TBF), including facial nerve palsy (FP), hearing loss, tinnitus, and dizziness on the quality of life of patients is often underevaluated. Thus, we retrospectively assessed 30 patients with TBF (26 men and 4 women) in our university tertiary referral center. They participated from injury onset to the final follow-up, over an 18-month period. Quality of life was estimated using validated questionnaires, such as the Facial Disability Index (FDI: physical and social), Hearing Handicap Inventory (HHI), Tinnitus Handicap Inventory (THI), and Dizziness Handicap Inventory (DHI). The FDI score was significantly worse in patients with severe initial (for physical FDI) and final facial palsy (for both physical and social FDI), mainly with immediate onset. The HHI score was statistically worse in patients with mixed hearing loss compared to those with conductive or sensorineural hearing loss and in those with profound hearing loss vs. normal hearing. The mixed TBF and the severity of hearing loss (especially profound hearing loss) were correlated with HHI, THI and DHI score values. In the long-term period after a TBF, moderate or severe facial palsy, mainly with immediate onset, may cause psychological distress, more easily resulting in social disability than functional impairment. Mixed TBF and mixed or profound hearing loss may also negatively influence quality of life.

Highlights

Academic Editor: In Seok MoonTemporal bone fracture (TBF) represents 14–22% of cranial fractures [1,2,3]
It has been reported that the facial nerve palsy (FP) has an important impact on functional abilities and social interaction [15,16]; this was confirmed by our results, as long-term physical and social Facial Disability Index (FDI) scores were worse in more pronounced FP palsy (HB grade) (Tables 2 and 5); no patient had severe FP in the long-term
The FP may contribute to psychological distress, which could result in social disability more than the functional impairment itself [17]; at follow-up, our patients with moderate FP had a poorer mean social FDI score than that of physical FDI

Summary

Introduction

Academic Editor: In Seok MoonTemporal bone fracture (TBF) represents 14–22% of cranial fractures [1,2,3]. The temporal bone is the thickest bone in the body, requiring excessive force to fracture; a TBF may occur in fresh human cadavers, when the applied force to the lateral skull is about. The complications of TBF include facial nerve palsy (FN), hearing loss (HL), which may be conductive, sensorineural, or mixed, and have a cerebrospinal fluid (CSF) leak [6,7,8]. All these sequelae of TBFs may adversely affect quality of life (QOL) with a psychological, emotional and social impact.

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