Clinical View of the Otorhinolaryngologist and Radiologist on the Classification of Fractures of the Temporal Bone

Czech version

Authors: Jana Šatanková ¹; Jana Dědková ²; Viktor Chrobok ¹
Authors‘ workplace: LF UK a FN Hradec Králové Klinika otorinolaryngologie LF UK a FN Hradec Králové a chirurgie hlavy a krku ¹; LF UK a FN Hradec Králové Radiologická klinika ²
Published in: Cesk Slov Neurol N 2017; 80/113(4): 457-463
Category: Short Communication
doi: https://doi.org/10.14735/amcsnn2017457

Overview

Introduction:
Temporal bone fractures are traditionally classified as transverse, longitudinal or mixed (according to the direction of fracture). However, this classification has shown little association with clinical symptoms and later progressive symptomatology, and therefore a new classification system has been introduced based on High-Resolution Computed Tomography. It includes the involvement of all parts of the temporal bone (processus mastoideus, pars squamosa, pars tympanica, pars petrosa) and involvement or sparing of the otic capsule (vestibule, cochlea, semicircular canals).

Methods:
We carried out a retrospective analysis of 89 patients with a fracture of the temporal bone using high-resolution computed tomography scans taken in the period from January 2003 to September 2013. We compared the correlation between the new classification of fractures of the temporal bone and the clinical symptoms.

Results:
Involvement of the petrous bone was associated with a higher incidence of sensorineural hearing loss, especially in patients with fractures affecting the otic capsule. In these cases, we found severe hearing impairments or deafness. The patients with petrous fracture affecting the otic capsule showed a higher incidence of facial palsy. The occurrence of dizziness, tinnitus and perforation of tympanic membrane was higher in petrous fractures, especially when the otic capsule was involved. There were no significant differences between non-petrous and petrous fractures in terms of the occurrence of otorrhoea and hemotympanum.

Conclusion:
The new classification of fractures according to the involvement of individual parts of the temporal bone has a better correlation with clinical symptoms.

Key words:
temporal bone – fracture – otic capsule – petrous bone – high-resolution computed tomography

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

耳鼻咽喉科与放射科骨科医师对颞骨骨折分类的临床观察

介绍：

传统上将颞骨骨折分为横向、纵向或混合（根据骨折的方向）。然而，这种分类与临床症状和后来的进展性症状没有太大关系，因此一个新的基于高分辨率计算机断层扫描技术的分类系统被引进。它包括颞骨的所有部分（乳突，鳞部，鼓部，岩部）和参与或保留的耳软骨囊（前庭，耳蜗，半规管）。

方法：

我们使用在2003年1月至2013年9月期间通过高分辨率计算机断层扫描技术获取的89例颞骨骨折患者的数据进行一项回顾性分析。我们比较了颞骨骨折新分类与临床症状之间的关系。

结果：

岩骨参与感觉神经性听力损失的发生率较高，特别是影响耳囊的骨折患者。在这些情况下，我们发现严重的听力障碍或耳聋。影响耳囊的岩部骨折患者发生面瘫的几率较高。岩部骨折尤其是涉及耳软骨囊时，发生眩晕，耳鸣，鼓膜穿孔的几率较高。非岩部骨折和岩部骨折患者在耳漏和鼓室积血发生率方面没有显着差异。

结论：

根据颞骨各个部位的涉及情况，骨折的新分类与临床症状有较好的相关性。

关键词：

颞骨骨折 - 耳膜 - 岩骨 - 高分辨率计算机断层扫描

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