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Long-term outcomes of pediatric temporal bone fractures with hearing loss: Results of a multinational database

Jason L Steele1, Heather J Smith2, Samira Takkoush3

  • 1University of Utah, Department of Otolaryngology - Head & Neck Surgery, United States; Rocky Vista University College of Osteopathic Medicine, United States.

International Journal of Pediatric Otorhinolaryngology
|December 25, 2024
PubMed

Insights

Pediatric temporal bone fractures (TBFs) with hearing loss significantly increase risks for meningitis and facial nerve disorders. These injuries may also elevate the likelihood of labyrinthitis, cerebrospinal fluid leaks, and cochlear implantation in children.

Area of Science:

  • Pediatric Otolaryngology
  • Neurosurgery
  • Trauma Surgery

Background:

  • Pediatric temporal bone fractures (TBFs) are associated with severe complications like meningitis, hearing loss requiring cochlear implantation (CI), facial nerve weakness, cerebrospinal fluid (CSF) leak, and labyrinthitis.
  • Understanding the specific risks of these outcomes in pediatric TBF patients with hearing loss is crucial for effective management.

Purpose of the Study:

  • To determine the risks of meningitis, CI, facial nerve disorders, CSF leak, and labyrinthitis in pediatric patients with TBF and hearing loss.
  • To compare these risks against a matched cohort of pediatric patients without TBF.

Main Methods:

  • A retrospective cohort study utilized the multinational TriNetX database.
  • Identified pediatric patients (<18 years) with diagnostic codes for skull base fractures and hearing loss as a proxy for TBF.
  • Age- and sex-matched controls were selected; 1:1 propensity-score matching (PSM) was applied to calculate risk ratios.

Main Results:

  • The study included 2739 pediatric patients with TBF and 2739 controls.
  • Pediatric TBF patients showed a significantly higher risk of meningitis (RR: 2.90) and facial nerve disorders (RR: 13.44).
  • Pre-PSM analysis indicated substantially increased risks for labyrinthitis (RR: 43.12), CI (RR: 21.61), and CSF leak (RR: 89.08) in the TBF cohort.

Conclusions:

  • Pediatric TBF with hearing loss elevates the risk of subsequent meningitis and facial nerve disorders.
  • There is a potential for increased risk of labyrinthitis, CSF leak, and the need for cochlear implantation in these pediatric patients.
Abstract

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