Hearing Preservation After Penetrating Cochlear Injury

Area of Science:

• Otolaryngology
• Neurosurgery
• Trauma Surgery

Background:

• Penetrating cochlear injuries are rare but severe, often resulting from ballistic trauma.
• These injuries pose significant risks to auditory function, facial nerve integrity, and major vascular structures.

Observation:

• A case report details the management of a patient with a penetrating cochlear injury caused by a projectile.
• The injury resulted in a traumatic cochleostomy, narrowly missing the facial nerve and intracranial carotid artery.

Findings:

• Postoperative audiometry revealed a pure tone average of 47.5 dB (air conduction) and 35 dB (bone conduction), with high-frequency hearing loss.
• Word Recognition Score was 76%, indicating moderate speech comprehension deficits.

Implications:

• Prompt surgical intervention is crucial for mitigating hearing loss in penetrating cochlear injuries.
• Minimizing intraoperative inner ear trauma and utilizing steroid therapy for posttraumatic labyrinthitis are key management strategies.
• This case underscores the importance of a multidisciplinary approach in managing complex head and neck trauma.