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

Previous Articles     Next Articles

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

PDF (PC)

522

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
[1] Isaacson B. Anatomy and surgical approach of the ear and temporal bone[J]. Head Neck Pathol, 2018, 12(3): 321-327. doi:10.1007/s12105-018-0926-2.
[2] Brodie HA, Thompson TC. Management of complications from 820 temporal bone fractures[J]. Am J Otol, 1997, 18(2): 188-197.
[3] Chadha S, Kamenov K, Cieza A. The world report on hearing, 2021[J]. Bull World Health Organ, 2021, 99(4): 242-242A. doi:10.2471/blt.21.285643.
[4] 许嘉, 伊海金.正确处理颞骨骨折耳科并发症[J].山东大学耳鼻喉眼学报, 2020, 34(1): 4-8.doi:10.6040/j.issn.1673-3770.1.2019.048. XU Jia, YI Haijin. Standardized treatment of auricular complications with temporal bone fractures[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 4-8. doi:10.6040/j.issn.1673-3770.1.2019.048.
[5] Sonya Wexler, Erica Poletto, Sri Kiran Chennupati.Pediatric Temporal Bone Fractures: A 10-Year Experience[J].Pediatric emergency care, 2017, 33(11):745-747.
[6] Kanona H, Anderson C, Lambert A, et al. A large case series of temporal bone fractures at a UK major trauma centre with an evidence-based management protocol[J]. J Laryngol Otol, 2020, 134(3): 205-212. doi:10.1017/s0022215120000419.
[7] Lee D, Honrado C, Har-El G, et al. Pediatric temporal bone fractures[J]. Laryngoscope, 1998, 108(6): 816-821. doi:10.1097/00005537-199806000-00008.
[8] Wexler S, Poletto E, Chennupati SK. Pediatric temporal bone fractures: a 10-year experience[J]. Pediatr Emerg Care, 2017, 33(11): 745-747. doi:10.1097/PEC.0000000000000594.
[9] Brodie HA, Thompson TC. Management of complications from 820 temporal bone fractures[J]. Am J Otol, 1997, 18(2): 188-197.
[10] Ort S, Beus K, Isaacson J. Pediatric temporal bone fractures in a rural population[J]. Otolaryngol Head Neck Surg, 2004, 131(4): 433-437. doi:10.1016/j.otohns.2004.04.006.
[11] Ulug T, Arif Ulubil S. Management of facial paralysis in temporal bone fractures: a prospective study analyzing 11 operated fractures[J]. Am J Otolaryngol, 2005, 26(4): 230-238. doi:10.1016/j.amjoto.2005.01.004.
[12] Ahmet Erim Pamuk, Gözde Pamuk, Münir Demir Bajin, et al.Traumatic Facial and Vestibulocochlear Nerve Injury in The Internal Acoustic Canal in The Absence of A Temporal Bone Fracture[J].The journal of international advanced otology, 2018, 14(2):330-333.
[13] Corrales CE, Monfared A, Jackler RK. Facial and vestibulocochlear nerve avulsion at the fundus of the internal auditory canal in a child without a temporal bone fracture[J].Otol Neurotol, 2010, 31(9):1508-1510. doi:10.1097/mao.0b013e3181f0c848.
[14] Kang HM, Kim MG, Hong SM, et al. Comparison of temporal bone fractures in children and adults[J]. Acta Otolaryngol, 2013, 133(5): 469-474. doi:10.3109/00016489.2012.754995.
[15] Montava M, Mancini J, Masson C, et al. Temporal bone fractures: sequelae and their impact on quality of life[J]. Am J Otolaryngol, 2015, 36(3): 364-370. doi:10.1016/j.amjoto.2014.12.011.
[16] Perheentupa U, Kinnunen I, Grénman R, et al. Management and outcome of pediatric skull base fractures[J]. Int J Pediatr Otorhinolaryngol, 2010, 74(11): 1245-1250. doi:10.1016/j.ijporl.2010.07.023.
[17] 倪鑫, 张天宇. 实用儿童耳鼻咽喉头颈科学[M]. 2版. 北京: 人民卫生出版社, 2021.
[1] WANG Min, LIU Hao, JIANG Luhan, TAN Liyue, LI Wen, FU Xiaolong. Packaging of AAV-ie-Tnfaip8l2 and its effect on improving auditory function in Tnfaip8l2-/- mice [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 7-15.
[2] WANG Menghui, LI Ao, WEI Hao, JIANG Yue, WU Xingguang, LI Luxi, QIAN Xiaoyun. Multiple mechanisms and clinical warning signs of deafness caused by hepatitis B virus [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 110-114.
[3] WANG Kaijian, WANG Wei, CHEN Xuesheng, FAN Chunsun, HE Yingying, HUANG Dongling, QIAN Cunhui, DING Shujun. Correlation between neutrophil-to-lymphocyte ratio with hearing loss and audiometric thresholds in adults: a cross-sectional study based on NHANES [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 18-28.
[4] TAO Duoduo, SHI Bin, ZHAO Yunshu, LI Yonggang, LIU Jisheng. Preliminary study on neurotransmitter levels in the anterior cingulate cortex and their relationship with hearing levels in patients with age-related hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 31-39.
[5] ZHENG Zehao, WEI Jiali, LIU Jiatao, ZHOU Yuqi, SUN Wenting, LI Yuxuan, BAI Peng. Evaluation of the efficacy and safety of site-specific acupuncture for the treatment of sudden hearing loss: a systematic review and network Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 114-127.
[6] LI Jie, SU Weina, LIN Qian, ZHANG Qishu, HOU Cheng, YANG Zhenjiao, XIANG Lili. Genetic analysis of MARVELD2 gene variants in two deafness cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 128-134.
[7] YUE Bingyan, ZOU Jian, LEI Lei, WEN Qiao, QIAN Yingxue. Tonsillar microbiota of children, immune regulation and diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 193-200.
[8] DONG Lingkang, YU Dongzhen. Trends and projections of the burden of age-related hearing loss in China from 1990 to 2021 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 61-69.
[9] ZHANG Lixia, LI Lin. Research on screening the key genes of age-related hearing loss by GEO database [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 104-114.
[10] LIN Yushan, LU Biaoqing. Personalized use of batroxobin in the treatment of sudden sensorineural hearing loss with full frequency decline [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 115-121.
[11] WANG Xin, YUAN Jingjing, HAO Pengpeng, YAN Zhanfeng, LIU Jianhua, ZHONG Liqun, LIU Siming, WU Wei, ZHAO Xiaoyang, ZHANG Ying. Protective effect of Chinese herbal medicine on sudden sensorineural hearing loss: a retrospective analysis and network pharmacology [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 6-17.
[12] PAN Jiayu, ZHANG Chunlin. Research advances on the etiology and pathogenesis of acute low-frequency sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 126-131.
[13] GUO Xiang, MA Yongqiang, YI Haijin. Current status and advances in magnetic resonance imaging in sudden deafness [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 140-144.
[14] CHEN Danping, HE Zijian, YU Youjun, ZHOU Xiaowei. Analysis of the efficacy and prognostic factors of hospitalized cases of children with sudden sensorineural hearing loss for ten years [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 16-22.
[15] LUO Lu, ZHOU En, XIAO Xuping, LIN Zhiqiang, FANG Zhijie, LYU Xiaohong. Application of plasma pointlike excitation technology in children with obstructive sleep apnea undergoing tonsillectomy and adenoidectomy combined with perioperative enhanced recovery after surgery program [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 26-30.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd