Pediatric temporal bone trauma will be addressed separately, as presentation, treatment, and prognosis differ in this population compared with adults.ĭiagram of the paired temporal bones (shaded) in relation to the human skull. A brief description of the anatomy and function of the temporal bone will be presented, followed by a discussion of current guidelines in diagnosing and treating injuries to this structure. Complications can include intracranial hemorrhage, cerebral contusion, meningitis, hearing loss, and facial paralysis, all of which may result in death or permanent deficits. This article will focus on the diagnosis and treatment of temporal bone trauma, as these injuries can have drastic consequences if they are not recognized and treated promptly and effectively. Iatrogenic trauma to temporal bone structures can also occur, and is usually the result of inadvertent surgical injury to the internal ear or facial nerve. Because the temporal bone encloses the middle and internal ear, these structures can be damaged by penetrating or concussive trauma to the tympanic membrane through the external acoustic meatus without temporal bone fracture. Motor vehicle accidents are the most common cause, with falls and gunshot wounds contributing to a lesser extent. Temporal bone trauma is usually the result of blunt head injury and patients commonly suffer from multiple other body injuries. Children generally recover from temporal bone trauma with fewer complications than adults and experience a markedly lower incidence of facial nerve paralysis. Conductive hearing loss can be corrected surgically as an elective procedure, while sensorineural hearing loss carries a poor prognosis, regardless of management approach. Patients with declining facial nerve function are candidates for early surgical intervention. Emergent intervention is required in situations involving herniation of the brain into the middle ear cavity or hemorrhage of the intratemporal carotid artery. Diagnosis relies primarily on physical signs and symptoms as well as radiographic imaging. To prevent these complications, diagnosis followed by appropriate medical and surgical management is critical. Complications can include intracranial hemorrhage, cerebral contusion, CSF leak and meningitis, hearing loss, vertigo, and facial paralysis. Trauma is usually the result of blunt head injury and can result in damage to the brain and meninges, the middle and internal ear, and the facial nerve. The temporal bones are paired structures located on the lateral aspects of the skull and contribute to the skull base.
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