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Progressive hearing loss after transverse temporal bone fracture

A T Lyos1, M A Marsh, H A Jenkins

  • 1Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex, USA.

Archives of Otolaryngology--Head & Neck Surgery
|July 1, 1995
PubMed
Summary

Transverse fractures can cause profound hearing loss by damaging the inner ear. Early diagnosis and surgical closure of perilymphatic fistulas can preserve hearing in some patients.

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Radiology

Background:

  • Transverse temporal bone fractures frequently involve the otic capsule.
  • These fractures commonly lead to immediate, severe sensorineural hearing loss.
  • Pathogenic mechanisms include direct cochlear nerve trauma, labyrinthine disruption, vascular compromise, hemorrhage, perilymphatic fistula, and endolymphatic hydrops.

Observation:

  • Three patients with transverse fractures and residual hearing were identified.
  • Progressive hearing deterioration occurred in these patients post-trauma.
  • Middle-ear exploration was performed to address suspected perilymphatic fistulas.

Findings:

  • Surgical closure of perilymphatic fistulas preserved hearing in two of the three patients.

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  • This highlights the potential for hearing recovery even after initial insult.
  • Timely intervention is crucial for managing hearing loss secondary to otic capsule fractures.

    • Implications:

    • Early audiometric assessment is vital for detecting hearing deficits after head trauma.
    • High-resolution computed tomography (CT) of the temporal bones aids in identifying otic capsule fractures and pneumolabyrinth.
    • A high clinical suspicion for perilymphatic fistulas is essential for prompt diagnosis and treatment, potentially preventing further hearing loss.