Temporal bone fractures in patients with head injury: A retrospective one year study.

Abstract

OBJECTIVE: Head trauma is a common injury to which all of us are susceptible because of high speed travel. Skull fracture affects 23-66% of patients with head trauma and approximately 4-30% of head injuries involve fracture of cranial base, including 18-75% of temporal bone. MATERIALS AND METHODS: We performed a retrospective one year review of 585 cases of head injury treated in our Hospital’s Emergency Department and sent to the Radiology Department for CT Scan of Head  from September 2014- August 2015. We aimed to evaluate the incidence and types of temporal bone fractures associated with head injury and to analyse these fractures by age, gender distribution, cause of injury, clinical presentation, site of involvement and outcome. RESULTS: Out of 585 patients, 71 patients were diagnosed to have temporal bone fracture. The incidence in our study was 12.1%. Majority of the patients were male 87.32% and were between 30-40 years of age 50.7%. The major cause of injury was found to be Motor vehicle accidents (MVA) 84.5%. The right side was involved more than the left side 63.38% of the cases. Most of the patients clinically present with otorrhea 53.52%. and the next common presentations were otalgia and otorhinorrhea 14.08%. Longitudinal type of fracture was most frequent accounts for about 63.38% of the cases. The most commonly involved part was petromastoid portion of the temporal bone 81.69%. Because of trivial head injury 21.12% of the patients died.CONCLUSION: The temporal bone fracture is frequently associated with severe traumatic brain injury leading to serious long term morbidity and sequelae. These injuries are frequently overlooked while treating more life threatening injuries in emergency departments.  Computerized tomography of high resolution in temporal bones is helpful in early detection of the fracture and its extensions.