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Predicting complications of pediatric temporal bone fractures
Raj D Dedhia1, Oliver Y Chin2, Matthew Kaufman3
1Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
International Journal of Pediatric Otorhinolaryngology
|September 9, 2020
Summary
Pediatric temporal bone fractures involving the otic capsule or associated with moderate/severe traumatic brain injury (TBI) have higher complication rates. Glasgow Coma Scale (GCS) predicts facial nerve injury and CSF leaks.
Area of Science:
- Pediatric Otolaryngology
- Neurosurgery
- Trauma Surgery
Background:
- Temporal bone fractures in children are uncommon but can lead to significant complications.
- Understanding risk factors is crucial for managing pediatric head trauma.
Purpose of the Study:
- To characterize complications of pediatric temporal bone fractures.
- To identify predictive risk factors for these complications.
Main Methods:
- Retrospective review of pediatric temporal bone fractures (2003-2017).
- Data collected included demographics, injury mechanism, fracture type, CT findings, and outcomes.
- Outcomes assessed: facial nerve injury (FNI), cerebrospinal fluid (CSF) leak, sensorineural hearing loss (SNHL), and conductive hearing loss (CHL).
Main Results:
- 117 patients with 129 fractures were analyzed.
- Otic capsule violating (OCV) fractures showed higher rates of CSF leak (20% vs 2%) and FNI (60% vs 5%) than otic capsule sparing (OCS) fractures.
- Moderate/severe traumatic brain injury (TBI) (Glasgow Coma Scale [GCS] < 13) was associated with significantly more complications (23% vs 5%).
Conclusions:
- Otic capsule violating (OCV) and transverse temporal bone fractures are linked to higher complication rates.
- Glasgow Coma Scale (GCS) is a predictive factor for facial nerve injury (FNI) and CSF complications in pediatric temporal bone fractures.
