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Paediatric temporal bone fractures: a single centre experience
Arash Algouneh1, Edward Madou1,2, Karan Gandhi1,2
1Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Insights
Pediatric temporal bone fractures, especially otic capsule violating (OCV) types, present significant challenges. Early detection and management are crucial for better outcomes in children.
Area of Science:
- Pediatric Traumatology
- Neurosurgery
- Otolaryngology
Background:
- Temporal bone fractures in children are uncommon but can lead to severe complications.
- Understanding the specific characteristics and outcomes is essential for optimal patient care.
Purpose of the Study:
- To evaluate the clinical features, management strategies, and outcomes of pediatric temporal bone fractures.
- To compare outcomes between otic capsule sparing (OCS) and otic capsule violating (OCV) fractures.
Main Methods:
- Retrospective analysis of pediatric skull fractures confirmed by imaging between January 2010 and December 2022.
- Data collected included demographics, injury mechanisms, clinical presentations, and complications.
- Fractures were classified as OCS or OCV.
Main Results:
- Out of 369 skull fractures, 88 (24%) involved the temporal bone, primarily from falls and vehicle accidents.
- Common symptoms included loss of consciousness, hematoma, and hemotympanum; 3.4% experienced facial nerve injury or CSF leaks.
- OCV fractures were associated with more severe complications, including hearing loss, affecting 35% of patients.
Conclusions:
- Pediatric temporal bone fractures, particularly OCV types, represent a significant clinical challenge.
- Prompt diagnosis and comprehensive management are vital for minimizing long-term sequelae.
- Consistent data collection and regular audiological monitoring are recommended.
Objective:
This study aimed to evaluate clinical characteristics, treatments and outcomes of paediatric temporal bone fractures at our institute.
Methods:
A retrospective study of paediatric skull fractures confirmed by imaging from January 2010 to December 2022. Data on demographics, clinical presentations, injury mechanisms and complications were analysed, and fractures were categorised into otic capsule sparing (OCS) and violating (OCV).
Results:
Of 369 skull fracture cases, 88 (24 per cent) involved temporal bones, predominantly caused by falls and vehicle accidents. Common symptoms were loss of consciousness, hematoma, and hemotympanum, with complications like facial nerve injury and cerebrospinal fluid leaks in 3.4 per cent of cases. OCV fractures led to more severe complications, including hearing loss. Audiology showed 65 per cent without hearing impairment, while others had various degrees of loss.
Conclusion:
Paediatric temporal bone fractures, particularly OCV types, pose significant challenges. Early detection and thorough management are vital, underscoring the need for consistent data collection and regular audiometric monitoring.
