Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (1): 13-19.doi: 10.6040/j.issn.1673-3770.0.2021.436

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Clinical characteristics and management of pediatric temporal bone fractures

MA Ning1,2, CHEN Min1,2, LIU Wei1,2, YANG Yang1,2, SHAO Jianbo1,2, HAO Jinsheng1,2, LIU Bing1,2, ZHANG Xiao1,2, DUAN Xiaomin3, ZHANG Qifeng3, ZHANG Jie1,2   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China;
    2. Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing 100045, China;
    3. Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
  • Online:2022-01-10 Published:2022-02-22

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Abstract: Objective To summarize the clinical characteristics and treatment strategies of temporal bone fracture in children. Methods Medical records of 477 children under 18 years old who were diagnosed with temporal bone fracture in Beijing Children's Hospital from July 2014 to July 2021 were retrospectively analyzed. Including age, gender, injury causes, imaging, facial nerve and audiological assessment, complications, treatment and prognosis. Results 483 sides of 477 children,6 of which were bilateral. The age range was from birth to 18 years old, the median age was 9 years old, and the male to female ratio was 3.01∶1. Traffic accidents were the main cause of injuries, accounting for 57.23%, followed by falls, accounting for 23.69%. The most common clinical symptoms are tympanema and ear hemorrhage, which usually disappear from 3 weeks to 1 month. Longitudinal fracture accounted for 52.38%, transverse fracture 35, 7.25%; 48 cases of mixed fracture, accounting for 9.93%, and 147 cases, accounting for 30.43%, which could not be classified, were presented as minor fracture lines.372 cases(77.02%)had hearing impairment. Facial nerve injury occurred in 28 cases(5.80%), including 8 cases of internal auditory canal injury. Cerebrospinal fluid otorrhea(CSF)was found in 47 cases(9.73%). Tympanic membrane perforation occurred in 15 cases(3.11%). 6.35% with intracranial injury. 3.98% complicated with multiple fractures or multiple organ injuries. There were 10 cases of immediate facial paralysis, 1 case recovered well, accounting for 10.00%, and 18 cases of delayed facial paralysis, 15 cases recovered well, accounting for 83.33%. 10 cases were treated by operation, including 8 cases of tympanum exploration and ossicular chain reconstruction. Facial nerve HB Ⅴ was recovered to HB Ⅱafter decompression in 2 cases. Conclusion Temporal bone fracture in children is most common in boys, and the most common cause of injury is traffic accident. Tympanic hemorrhage, tympanic membrane perforation, cerebrospinal fluid otorrhea and conductive deafness can be cured by conservative treatment. Trauma caused ossicular chain fracture or dislocation has a good prognosis by surgical treatment. Trauma caused internal auditory canal fracture can cause extremely severe sensorineural deafness and complete facial paralysis with poor prognosis.

Key words: Temporal bone fracture, Pediatric, Facial nerve injury, hearing loss, Cerebrospinal fluid leak

CLC Number: 

  • R764.3
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