Bilateral temporal bone fractures: a case report

Abstract

<p>Bilateral temporal bone fractures are rare; accounting for 9% to 20% of cases of temporal bone fractures. Clinical manifestations include hearing loss, facial paralysis, CSF otorhinorrhea and dizziness. This is a case report of a patient who presented with bilateral temporal bone fractures. This is a report of a 23-yr-old male who sustained bilateral temporal bone fractures and presented 18 days later with complaints of watery discharge from left ear and nose, bilateral profound hearing loss and facial weakness on the right side. Pure tone audiometry revealed bilateral profound sensori-neural hearing loss. CT temporal bones & MRI scans of brain were done to assess the extent of injuries. The patient underwent left CSF otorrhea repair, as the CSF leak was active and not responding to conservative management. One week later, the patient underwent right facial nerve decompression. The patient could not afford a cochlear implant (CI) in the right ear at the same sitting, however, implantation was advised as soon as possible because of the risk of cochlear ossification. The transcochlear approach was used to seal the CSF leak from the oval and round windows on the left side. The facial nerve was decompressed on the right side. The House-Brackmann grade improved from Grade V to grade III at last follow-up. Patients with bilateral temporal bone fractures require prompt assessment and management to decrease the risk of complications such as meningitis, permanent facial paralysis or hearing loss. </p>

Management of COVID-19-Positive Patient with Bilateral Longitudinal Petrous Fractures: A Case Report

“…These fractures are bilateral in 8 to 29% of cases. 1,5,6 Common complications of temporal bone fractures include facial nerve palsy, CSF leak, SNHL, conductive hearing loss, cholesteatoma formation, tympanic membrane perforation, hemotympanum, injuries to lower cranial nerves, and vascular injuries.…”

“…OCD fractures are associated with higher incidence of SNHL (sevenfold in one study), CSF leak (2-4fold), and facial nerve injury (30-50%). 6 High-resolution CT of the temporal bones is indicated when there is acute onset facial nerve paralysis, suspicion of an acute vascular injury, or another reason to prepare the patient for immediate or potential neurosurgical intervention. 2 The measures taken to stem the COVID-19 pandemic had influenced the neurosurgical workflow, which tries to maximize the capability to provide neurosurgical care to the patients while reducing the risk for health-care providers to a minimum.…”