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Hearing loss in pediatric temporal bone fractures: Evaluating two radiographic classification systems as
A Bhindi1, L Carpineta2, B Al Qassabi2
1Department of Otolaryngology-Head and Neck Surgery, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
Summary
Temporal bone fractures (TBF) in children rarely cause sensorineural hearing loss (SNHL), even when violating the otic capsule. Traditional and otic-capsule classifications do not predict conductive hearing loss or other otologic signs.
Area of Science:
- Otolaryngology
- Pediatric Traumatology
- Radiology
Background:
- Temporal bone fractures (TBF) are classified by fracture angle or otic-capsule involvement.
- Pediatric TBF classification and associated otologic dysfunction require further investigation.
Purpose of the Study:
- To compare hearing loss (HL) and otologic dysfunction rates in pediatric TBF patients using traditional (longitudinal, transverse, mixed) and otic-capsule (sparing vs. violating) classifications.
Main Methods:
- Retrospective review of pediatric TBF patients (2000-2014).
- CT scans classified TBFs as longitudinal (L), transverse (T), mixed (M), or otic-capsule sparing (OCS)/violating (OCV).
- Medical records analyzed for HL and otologic signs, comparing fracture types.
Main Results:
- 47 TBFs in 43 pediatric patients analyzed; 25 mixed, 18 longitudinal, 4 transverse.
- 33 OCS and 9 OCV fractures identified.
- Conductive HL (CHL) rates were similar across L, T, M, OCS, and OCV fractures (36-50%).
- Two cases of sensorineural HL (SNHL) occurred in OCV fractures, none in OCS (estimated difference 0.22; 95% CI 0.01-0.60).
- Hemotympanum was the most common sign (68% of TBFs).
Conclusions:
- Traditional and otic-capsule classifications did not predict CHL or other otologic signs in pediatric TBFs.
- OCV fractures showed a higher risk for SNHL, but incidence was lower than expected.
- Further research is needed to understand pediatric TBF sequelae.
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