Audiologic Patterns of Otic Capsule Preserving Temporal Bone Fracture: Effects of the Affected Subsites

Abstract

Objectives.This study was aimed to assess the relationship between the type of temporal bone area involved and conductive hearing loss.Methods.We enrolled 97 patients who visited the otolaryngology clinics of Seoul National University Hospital or Boramae Medical Center, Seoul Metropolitan Government-Seoul National University with temporal bone fracture between January 2004 and January 2014. Audiometric parameters, including initial and improved air-bone (AB) conduction gap values, were reviewed in accordance with the temporal bone computed tomography (external auditory canal [EAC], middle ear [ME], mastoid [M], and ossicle [O]).Results.Patients with ossicular chain involvement exhibited a larger AB gap compared to those with no ossicular chain involvement at 250, 1,000, 2,000, and 4,000 Hz. Among the groups without ossicular chain involvement, the initial AB gap was largest in patients with EAC+ME+M involvement, followed by the ME+M and M-only involvement groups. The greatest improvement in the AB gap was observed in the EAC+ME+M group followed by the ME+M and M-only groups, irrespective of ossicular chain involvement. Improvements in AB gap values were smallest at 2,000 Hz.Conclusion.Conductive hearing loss pattern differed according to the temporal bone area involved. Therefore, areas such as the hematoma and hemotympanum, as well as the fracture line of the temporal bone area, must be evaluated to predict audiologic patterns with otic capsule preserving temporal bone fracture.

Correlation of hearing outcome in otic capsule sparing temporal bone fractures using temporal bone sub-site classification: a cross-sectional descriptive study

“…Kim Correlation between hearing loss and otic capsule sparing fracture with temporal bone sub-sites showed very weak positive correlation (R value 0.2064). Study done by Kim So Young, et al showed CHL that occurred after otic capsule-sparing temporal bone fractures varied in accordance with the temporal bone sub-sites [6].…”

“…But this classification system fails to predict the severity of conductive hearing loss in otic capsule sparing temporal bone fractures [5]. So Young Kim et al studied various audiometric patterns in otic capsule sparing fractures and proposed a sub-site classification system to predict the severity of the hearing loss [6]. In this study, an attempt is being made to correlate the severity of the hearing loss in otic capsule sparing fracture patients based on the sub-site classification system.…”

Clinical Features of Fracture versus Concussion of the Temporal Bone after Head Trauma

“…Conductive hearing loss is due to middle ear injuries, such as hemotympanum and ossicular disruption. Kim, et al [15] reported larger air-bone gaps (AB gaps) in patients with ossicular chain involvement than in those with no ossicular chain involvement, which is caused by hematoma and hemotympanum. Grant, et al [16] reported that AB gaps decreased from 24.8 dB to 13.2 dB on average.…”

Revisión bibliográfica de la detección temprana de luxación incudomaleolar mediante imágenes tomográficas

“…Este síntoma generalmente va acompañado de otorragia y hemotímpano debido al daño de diferentes estructuras internas del oído. Diferentes estudios han demostrado la relación entre el tipo de fractura de hueso temporal y el tipo de pérdida auditiva encontrando que las fracturas longitudinales están más asociadas al tipo conductivo mientras que las transversales al tipo neurosensorial, afectando la calidad de vida de quien las padece (14)(15)(16)(17)(18)(19)(20). En los casos donde se presenta compromiso de estructuras laberínticas se observa una asociación a vértigo e hipoacusia neurosensorial (3)(4)(5).…”

“…En el oído medio la estructura más frecuentemente afectada es la cadena osicular, siendo de estas más frecuentes las luxaciones (93%) que las fracturas (7%) (4-5). La luxación incudoestapedial es la más frecuente en un 82% de los casos, y la luxación incudomaleolar en el 52%, asociada en la mayoría de los pacientes a fracturas de la apófisis larga del yunque, del cuerpo del estribo o de presentarse concomitantemente con luxaciones incudoestapediales (12)(13)(14)(15).…”