Otological Manifestations in Head Injury: Experience from a Tertiary Academic Centre

Head injuries are most commonly associated with serious otolaryngological involvement. This study was done to identify the otological manifestations and its sequelae among patients with head injury. A prospective study conducted in a tertiary care centre, among patients attending the Emergency medicine, Otorhinolaryngology and Neurosurgery departments from August 2017-July 2018 with head injury and associated otological manifestations. They were examined within 48 hours of admission and followed up for two months. There were 243 patients with head injury, among which 201 were male and 42 were female patients. Majority of them (44.8%) were between 21 and 40 years of age. Road traffic accidents (RTA) was the commonest cause of head injury occurring in 91.8% patients. Among them, 58 patients (23.9%) had otological manifestations, the most common symptom and sign being ear bleed (72.4%) and temporal bone fracture (46.6%) respectively followed by facial nerve palsy (24.1%) and hearing loss (22.4%). Temporal bone fracture had statistically significant association with ear bleed, hearing loss, facial palsy and CSF otorrhoea (p = 0.0001) and tympanic perforation (p = 0.03). Otological involvement occurred in almost one fourth of the patients with head injury, the most common serious complication being temporal bone fractures which was diagnosed in almost half of this population followed by facial nerve palsy. Ear bleed, hearing loss and CSF otorrhea are significant indicators of underlying temporal bone fractures, necessitating early ENT evaluation and HRCT temporal bones for timely detection and prevention of disabling otological complications.