Management of Bilateral Tympanic Bone Fracture: A Simple Venting Method

Tympanal bone fracture in forensic practice

“…TBFs are uncommon complications of head trauma [1][2][3]. In the rather scarce scientific literature on this topic, the most reported mechanism is high-energy mandibular trauma (with impact to the chin), during which the mandibular head is retropulsed into the glenoid fossa of the TMJ strongly enough to overpass the resistance of tendons, ligaments, and cartilage, resulting in impaction and fracture of the tympanal bone [2,5,8,[10][11][12]15]. TBFs are usually associated with mandibular fractures (Fig.…”

“…However, the evaluation of this tiny bone requires special attention from the clinical radiologist, as well as the forensic practitioner, and its visualization should not be forgotten. As a matter of fact, TBF can lead to chronic complications of importance in both the clinical and judiciary fields, notably EAC stenosis [ 1 , 2 , 5 , 11 , 12 ] with conductive hearing loss [ 8 , 11 ] and subsequent loss of income for the victim. Furthermore, TBF rarely causes cholesteatoma formation [ 11 , 14 ], which may require surgical treatment.…”

“…As a matter of fact, TBF can lead to chronic complications of importance in both the clinical and judiciary fields, notably EAC stenosis [ 1 , 2 , 5 , 11 , 12 ] with conductive hearing loss [ 8 , 11 ] and subsequent loss of income for the victim. Furthermore, TBF rarely causes cholesteatoma formation [ 11 , 14 ], which may require surgical treatment.…”

“…Typical clinical manifestations of acute TBF include otorrhagia [ 2 , 8 , 10 , 11 , 15 ] secondary to the skin lesion of the affected EAC and ossicular disruption (given the close anatomy of both structures) with hypoacusis [ 2 , 8 , 16 ] and limitation of mouth opening [ 2 , 8 , 11 , 16 ]. However, as we can see in the present study, such symptoms are not always present or clinically detected and TBF should be searched for even without symptoms.…”

“…Tympanal bone fracture (TBF) is an uncommon complication of blunt head trauma and is mostly associated with a mandibular or petrous bone fracture [1][2][3][4][5][6][7][8][9][10]. It can lead to several complications, including external auditory canal (EAC) stenosis [2,5,11,12] with conductive hearing loss [8,11]. For this reason, it deserves proper medical follow-up and the attention of the forensic pathologist due to the risk of long-term disability and loss of income.…”