Presentation
Clinical presentations mostly reported were blood rhinorrhea (36%) and blood otorrhea (32.7%). [ncbi.nlm.nih.gov]
Entire Body System
- Swelling
The patient returned within 6 hours with sudden unilateral neck swelling and stridor after blowing his nose. Flexible nasendoscopy and computed tomography showed extrinsic compression of the pharynx, with partial upper airway obstruction. [ncbi.nlm.nih.gov]
Since there is no room for swelling to occur, the nerve gets ‘squeezed’ within the facial canal, leading to nerve malfunction. [facialpalsy.org.uk]
Periauricular swelling and retroauricular ecchymosis ( Battle sign ) are common, and almost all have otorrhagia. [radiopaedia.org]
Moreover, blood is irritating and can cause edema or swelling as excess fluid leaks from the surrounding blood vessels. This is no different than the swelling that can occur surrounding a bruise on an arm or leg. [emedicinehealth.com]
- Pain
On physical examination there was trismus, inability to chew and local pain in the temporomandibular joint (TMJ) without tenderness and swelling. [ncbi.nlm.nih.gov]
The pain and drainage stopped after a few days but the hearing loss persisted. The patient reported a right temporal bone fracture 20 yrs previously, following a motorcycle accident. [rcsullivan.com]
Glasgow Coma Scale Eye Opening Spontaneous 4 To loud voice 3 To pain 2 None 1 Verbal Response Oriented 5 Confused, Disoriented 4 Inappropriate words 3 Incomprehensible words 2 None 1 Motor Response Obeys commands 6 Localizes pain 5 Withdraws from pain [emedicinehealth.com]
It consists of pain in the throat with foreign body sensation associated with difficult and painful swallowing. Referred otalgia is common. [emedicine.medscape.com]
- Asymptomatic
Asymptomatic (producing no symptoms) chronic subdural hematomas may be left to resolve on their own; however, it may require attention if the individual's mental status changes or further bleeding occurs. [emedicinehealth.com]
- Surgical Procedure
Certain surgical procedures may be available to help with eye closure and smiling. Last reviewed: 11-08-2016 || Next review due: 11-08-2018 [facialpalsy.org.uk]
Ears
- Hearing Impairment
Seven cases of profound hearing impairment following either unilateral or bilateral temporal bone fracture are presented who were implanted with the Nucleus 22 channel or Ineraid devices. Six patients suffered bilateral temporal bone fractures. [ncbi.nlm.nih.gov]
Pure tone audiometry revealed a mixed type severe hearing impairment (Figure 1A). [austinpublishinggroup.com]
Musculoskeletal
- Fracture
Fractures involve the otic capsule (arrow in A) and the carotid canal (arrow in B). • Approximately 4% of patients treated for head trauma have skull fractures (1) • 14–22% of patients with skull fractures have temporal bone fractures (1) • 3 most common [learningradiology.com]
Bilateral anterior longitudinal temporal bone fractures with ossicular injury Case 2. Left transverse temporal bone fracture with ossicular injury Case 3. Right complex temporal bone fracture Case 4. Right oblique temporal bone fracture [uwmsk.org]
RESULTS: Forty-eight patients with temporal bone fractures accounted for 17.00% of the homochronous craniofacial fractures. [ncbi.nlm.nih.gov]
- Joint Dislocation
Malleoincudal joint dislocation The malleoincudal joint is protected by the epitympanic recess. [scielo.br]
During the decompression, the tympanic membrane perforation will be repair and the ossicular chain dislocation (the most common form of ossicular discontinuity is incudostapedial joint dislocation) will be reconstruction. so, the presurgical conductive [facialent.net]
In those with persistent hearing loss, ossicular disruption, especially incudostapedial joint dislocation, is the most common abnormality. [ncbi.nlm.nih.gov]
Neurologic
- Vertigo
In both benign paroxysmal positional vertigo and central postural vertigo, the spontaneous nystagmus and vertigo usually resolve over 3-6 months and the remaining symptoms by 10-12 months; however, these symptoms may persist in elderly patients. [emedicine.medscape.com]
We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus. [ncbi.nlm.nih.gov]
Sensorineural hearing loss +/- vertigo after a temporal bone fracture implies traumatic audio/vestibular failure. The vertigo generally improves as the brain adapts, but hearing loss is likely to be persistent. [entsho.com]
If vertigo is caused by damage that cannot be repaired surgically, a benzodiazepine drug may provide some relief. [msdmanuals.com]
- Dizziness
All patients complained of hearing loss and dizziness. Hearing in most patients (83.3%) did not improve, whereas dizziness improved in 91.7% of patients. [ncbi.nlm.nih.gov]
Next, a specialized examination for dizziness will be performed. A good screening test for dizziness is to use v ideo-frenzel goggles, such as we use at Chicago Dizziness and Hearing. [dizziness-and-balance.com]
The diagram above shows why this fracture can cause hearing problems (middle ear) or dizziness (inner ear). There is usually no specific surgical intervention needed for this fracture. [regionstraumapro.com]
- Irritability
Flavor is determined by the aroma (smell), taste (sweet, sour, salty or bitter quality), texture, temperature and spiciness (or irritation) of food and beverages. All of these sensory experiences together form “flavor”. [nosmell.wordpress.com]
Moreover, blood is irritating and can cause edema or swelling as excess fluid leaks from the surrounding blood vessels. This is no different than the swelling that can occur surrounding a bruise on an arm or leg. [emedicinehealth.com]
Workup
This article reviews the current state of temporal bone fracture evaluation and management with special attention to mechanisms of injury, clinical presentations and emergency evaluation, and diagnostic workup, including the evolution of radiographic [ncbi.nlm.nih.gov]
Treatment
OBJECTIVE: To explore the characteristics and treatment of temporal bone fractures and injuries in the medial-inner ear. [ncbi.nlm.nih.gov]
Treatment Usually, The treatment of delayed-onset palsy is based on conservative, nonsurgical management. [facialent.net]
Results CT scans to determine damage and location Also use CT imaging to determine type of fracture MRI can determine fracture and presence of blood or CSF Expected Laboratory Results If there is drainage tests can be done to determine if it is CSF Treatment [haikudeck.com]
Prognosis
Prognosis : good. Pathogenesis Etiology Trauma. Pathophysiology Initially may cause little problem. Often go undiagnosed in absence of other trauma in area. With time, osseous callus forms causing progressive dimminution of jaw movement. [vetstream.com]
[…] post-traumatic cholesteatoma may also result w/surgery Audiology Outcomes/treatment surgery is an option to reconstruct ossicles/remove scar tissue outcome is generally good hearing aids are an option as well Expected Long term Sequelae In our case the prognosis [haikudeck.com]
These are discussed in detail in separate articles: longitudinal fractures transverse fractures mixed fractures Treatment and prognosis Treatment is based on managing facial nerve injury, hearing loss, vestibular dysfunction, and CSF leakage. [radiopaedia.org]
Etiology
We present a novel theory for the etiology of pneumolabyrinth in a trauma patient without an otic capsule fracture: passage of intrathecal air into the labyrinth. [ncbi.nlm.nih.gov]
Characteristics of reported cases of sympathetic hearing loss Author Age Baseline/preop Etiology threshold * Harris et al, (1) 30 15 Exc VS (TL) 1985 55 8 Exc VS (TL) 36 0 Exc VS (MF) 34 2 Exc VS (TL) 64 48 Exc VS (TL) Schindler and 44 NR Trauma Niparko [medical-dictionary.thefreedictionary.com]
Pathogenesis Etiology Trauma. Pathophysiology Initially may cause little problem. Often go undiagnosed in absence of other trauma in area. With time, osseous callus forms causing progressive dimminution of jaw movement. [vetstream.com]
Epidemiology
LEVEL OF EVIDENCE: Epidemiologic study, Level III. Copyright © 2016 Elsevier Ltd. All rights reserved. [ncbi.nlm.nih.gov]
Epidemiology Longitudinal fractures represent the majority (70-90%) of all petrous temporal bone fractures. Periauricular swelling and retroauricular ecchymosis ( Battle sign ) are common, and almost all have otorrhagia. [radiopaedia.org]
Pathophysiology
Variables included type and severity of hearing loss, as well as pathophysiology of hearing loss. RESULTS: There were 13 studies with 773 patients that met study criteria. [ncbi.nlm.nih.gov]
Pathophysiology Initially may cause little problem. Often go undiagnosed in absence of other trauma in area. With time, osseous callus forms causing progressive dimminution of jaw movement. [vetstream.com]
Abstract Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation [thieme-connect.com]
A combination of both central and peripheral causes are highly possible in the pathophysiology of vertigo after head and temporal bone trauma. Vestibular rehabilitation or canal repositioning may be of value, in particular in BPPV. [emedicine.medscape.com]
Prevention
CONCLUSIONS: To minimize or prevent the sequelae of TBF, accurate radiologic evaluation is necessary as soon as possible after injury. [ncbi.nlm.nih.gov]
Página 310 - A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. [books.google.es]
If the leak does not stop on its own within a few days, surgery or insertion of a drain near the spinal cord in the lower back (lumbar drain) may be needed to prevent infection. NOTE: This is the Consumer Version. [msdmanuals.com]