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Temporal bone fractures

B Nageris1, M C Hansen, W G Lavelle

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Massachusetts Medical Center, Worcester, MA 01655.

The American Journal of Emergency Medicine
|March 1, 1995
PubMed
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Emergency physicians must improve diagnosis and monitoring for blunt temporal bone fractures. Early evaluation and documentation are crucial for managing complications like CSF otorrhea and facial nerve paralysis.

Area of Science:

  • Emergency Medicine
  • Neurosurgery
  • Trauma Surgery

Background:

  • Blunt temporal bone fractures are associated with significant head injuries.
  • Complications such as CSF otorrhea and facial nerve paralysis require prompt recognition and management.

Purpose of the Study:

  • To review the diagnosis and monitoring of blunt temporal bone fractures in an emergency department setting.
  • To identify shortcomings in the initial evaluation and ongoing patient monitoring.

Main Methods:

  • Retrospective review of 104 trauma patients with closed head injury over a four-month period.
  • Analysis of 15 patients diagnosed with temporal bone fracture and their subsequent management and outcomes.

Main Results:

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  • 15 patients with temporal bone fracture were identified; 12 survived.
  • Four patients developed CSF otorrhea and two developed facial nerve paralysis, all resolving with conservative management.
  • Significant deficiencies were noted in initial facial nerve examinations and inpatient monitoring for complications.

    • Conclusions:

    • There is a critical need for improved initial diagnosis and documentation of temporal bone fractures by emergency physicians.
    • Enhanced monitoring protocols are necessary to effectively manage potential complications like CSF otorrhea and facial nerve paralysis.