Temporal bone fractures. Vestibular and other related ear sequele

Vertigo is a common symptom after head injuries, though often overlooked in the acute stage due to other concomitant manifestations. According to previous investigations the mechanisms of injury to the vestibular system cannot be defined as clearly as for the auditory system. Twenty patients with temporal bone fractures were reviewed and later re-examined. The results of conventional X-ray, computerized tomography, clinical, otoneurological and audiological findings were analysed. The sequelae of dizziness and auditory defects were considered and follow-ups with computerized electro-oculography were performed. Radiological evaluation revealed fractures in approximately 65%. Half complained of dizziness and positional nystagmus was the most common vestibular observation. In 25% of the patients, dizziness remained to some degree. Hearing was permanently impaired in 75%. The hearing impairment depended in 20% on fractures of the ossicular chain and in 55% on sensorineural hearing loss. In those cases where a conductive hearing loss persisted, surgery on the middle ear was indicated. The vestibular system is not so vulnerable as the auditory system. Conductive hearing loss disappeared spontaneously or could be relieved by surgery. The vestibular symptoms improved or disappeared in all cases, whereas not infrequently, a sensorineural hearing loss remained.