Temporal Bone Trauma Management: A Study of 100 Cases.

Abstract

To address the management of complications after temporal bone fractures and the outcomes. A prospective clinical study of 100 patients from the Department of Trauma (Surgery + E.N.T.), P.D.U. Medical College, Rajkot between the time period of 2017-2019. Among 100 patients, 79 were males and 21 were females. The most affected age group was 16-45years (72). The longitudinal fracture (90) is the most common type of fracture, in which non-petrous type is the most prevalent (88) as low impact injuries are more common. The most common presentations of temporal bone fracture are ear bleed (59) and decreased hearing (59), mostly over the side of trauma. The most common clinical finding is hearing impairment (59), followed by haemotympanum (20) and facial palsy (15), more common over the side of trauma. Facial palsy had been easily managed conservatively by steroids and physiotherapy in most of the cases. 12 out of 15 patients had good recovery i.e. upto grade I and II by conservative management, 3 had undergone facial nerve decompression, following which 1 had recovered completely, i.e. grade 1; 1 upto grade II while 1 did not show any improvement. Other complications included giddiness (18), trigeminal neuralgia (1) and abducens nerve palsy (1). The temporal bone is more prone to injury and complications following trauma like hearing impairment, cerebrospinal fluid leak and facial palsy resolve either spontaneously or with conservative management. Surgeries must be undertaken only if adequate conservative treatment fails and after proper investigations.