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Temporal Bone Fractures Caused by Ballistic Projectiles: A Systematic Review
Kenneth L Kennedy1, Elizabeth Cash1, Jessica Petrey1
1Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville, Louisville, Kentucky, USA.
Summary
Gunshot wounds to the temporal bone are rare but severe, damaging vital structures. This review analyzes outcomes and calls for better research to guide future care for these complex ballistic injuries.
Area of Science:
- Otolaryngology
- Neurosurgery
- Trauma Surgery
Background:
- Ballistic injuries to the temporal bone are uncommon yet devastating.
- These injuries compromise critical neurovascular structures, leading to significant morbidity.
Purpose of the Study:
- To review and characterize outcomes following ballistic temporal bone injuries.
- To identify needs for standardized, high-quality future research in this area.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane databases.
- Inclusion criteria: adult patients with temporal bone fractures from gunshot wounds surviving >48 hours; exclusion of case reports.
- Six studies met inclusion criteria from 139 initial results.
Main Results:
- Included studies were primarily low-level evidence case series.
- Reported outcomes encompassed demographics, audiologic status, vascular and intracranial complications, facial nerve function, and surgical interventions.
- Significant variability in hospital course and patient outcomes was observed.
Conclusions:
- This review is the first to characterize the nature and progression of temporal bone gunshot wounds.
- Existing literature consists of small, dated case series, highlighting a need for improved research.
- Findings provide a foundation for future studies to guide clinical management of these injuries.
