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[Severe temporal bone fractures in children: clinical presentation, complications and sequelae observed in the last
A J Castellanos-Alcarria1, A Navarro-Mingorance1, S B Reyes-Domínguez1
1Unidad de Cuidados Intensivos Pediátricos, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
Objectives:
To evaluate the clinical presentation, complications and sequelae in patients with temporal bone fracture in the last 11 years.
Material And Methods:
A total of 27 patient medical records were retrospectively analysed.
Results:
Of the 27 patients who were admitted for temporal bone fracture from 2001 to 2012, 13 (48%) had no petrous involvement (Group 1), and 14 (52%) with petrous involvement (Group 2). Patients in Group 2 had a longer P-ICU stay: median 4.5 days (RI: 2.75-22.25 d) vs 2 (RI: 1-3 d) (P=.018); more days on mechanical ventilation support: median 3 days (RI: 1.50-17 d) vs 1 (RI: 1-1.25 d). This group also had a higher frequency in sequelae (P=.04 OR=1.4 (95% CI: 1.05-1.95)) and a higher incidence in cerebrospinal fluid (CSF) fistula (P<.02; OR 2.33; 95% CI (1.27-4.27)). Severity scores (PRIMS III and PTI) showed no significant differences. Some degree of hearing loss was observed in 31% of the patients. Traffic accident was the main cause of trauma (33%), followed by falls (27%). There were 2 deaths and 4 (15%) had permanent sequelae.
Conclusions:
Isolated temporal bone fractures usually have a good outcome in children, but in some cases they can be fatal or have permanent sequelae. Long term follow up is recommended by authors.
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