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An association between imaging and acute posttraumatic ear bleeding with trismus

E Avrahami1, R Katz

  • 1Department of Radiology, Wolfson Medical Center, Holon, Israel.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|April 16, 1998
PubMed
Summary

Computed tomography (CT) is the recommended initial imaging for patients with ear bleeding and trismus. This approach avoids doubling radiation dose and imaging costs compared to other initial procedures.

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Area of Science:

  • Radiology
  • Trauma Surgery
  • Otolaryngology

Background:

  • Unilateral ear bleeding and trismus following trauma can indicate underlying fractures.
  • Accurate diagnosis is crucial for appropriate patient management and to avoid complications.

Purpose of the Study:

  • To correlate computed tomography (CT) findings with specific fracture types in patients presenting with unilateral ear bleeding and trismus.
  • To evaluate the efficacy and cost-effectiveness of CT as an initial diagnostic tool.

Main Methods:

  • Ninety-four patients with unilateral ear bleeding and trismus underwent CT scans, including coronal views of temporomandibular joints and axial views of temporal bones where indicated.
  • Maximal mandibular movements were clinically assessed in patients and control subjects.

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  • Radiation dose and imaging costs were quantified.

    • Main Results:

    • CT identified two main fracture patterns in symptomatic patients: bilateral temporomandibular joint fractures (68 cases) and comminuted temporal bone fractures (26 cases).
    • Specific subtypes of temporomandibular joint fractures included bilateral high condylar fractures and combinations of ipsilateral high condylar with contralateral subcondylar dislocation.
    • Comminuted petrous bone fractures were identified ipsilateral to the ear bleeding in patients with intact temporomandibular joints.

    Conclusions:

    • Computed tomography (CT) should be the primary imaging modality for patients with post-traumatic ear bleeding and trismus.
    • Utilizing CT as the initial evaluation significantly reduces radiation exposure and healthcare costs compared to alternative initial imaging strategies.