| Title: |
Temporal Bone Fractures and Related Complications in Pediatric and Adult Cranio-Facial Trauma : A Comparison of MDCT Findings in the Acute Emergency Setting |
| Authors: |
Kohler, Romain; Pucci, Marcella; Landis, Basile Nicolas; Senn, Pascal; Poletti, Pierre-Alexandre Alois; Scolozzi, Paolo; Toso, Seema; Becker, Minerva; Platon, Alexandra |
| Source: |
ISSN: 2379-1381 ; Tomography, vol. 10, no. 5 (2024) p. 727-737. |
| Publication Year: |
2024 |
| Collection: |
Université de Genève: Archive ouverte UNIGE |
| Subject Terms: |
info:eu-repo/classification/ddc/616.8; info:eu-repo/classification/ddc/616.0757; info:eu-repo/classification/ddc/617; CT; Cranio-facial trauma; Emergency radiology; Temporal bone trauma |
| Description: |
Purpose: The purpose of this study was to analyze the prevalence of and complications resulting from temporal bone fractures in adult and pediatric patients evaluated for cranio-facial trauma in an emergency setting. Methods: A retrospective blinded analysis of CT scans of a series of 294 consecutive adult and pediatric patients with cranio-facial trauma investigated in the emergency setting was conducted. Findings were compared between the two populations. Preliminary reports made by on-call residents were compared with the retrospective analysis, which was performed in consensus by two experienced readers and served as reference standard. Results: CT revealed 126 fractures in 116/294 (39.5%) patients, although fractures were clinically suspected only in 70/294 (23.8%); p < 0.05. Fractures were longitudinal, transverse and mixed in 69.5%, 10.3% and 19.8% of cases, respectively. Most fractures were otic-sparing fractures (95.2%). Involvement of the external auditory canal, ossicular chain and the osseous structures surrounding the facial nerve was present in 72.2%, 8.7% and 6.3% of cases, respectively. Temporal bone fractures extended into the venous sinuses/jugular foramen and carotid canal in 18.3% and 17.5% of cases, respectively. Vascular injuries (carotid dissection and venous thrombosis) were more common in children than in adults (13.6% versus 5.3%); however, the observed difference did not reach statistical significance. 79.5% of patients with temporal bone fractures had both brain injuries and fractures of the facial bones and cranial vault. Brain injuries were more common in adults (90.4%) than in children (63.6%), p = 0.001. Although on-call residents reliably detected temporal bone fractures (sensitivity = 92.8%), they often missed trauma-associated ossicular dislocation (sensitivity = 27.3%). Conclusions: Temporal bone fractures and related complications are common in patients with cranio-facial trauma and need to be thoroughly looked for; the pattern of associated injuries is slightly different ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38787016; unige:177788 |
| Availability: |
https://archive-ouverte.unige.ch/unige:177788 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.269AD58F |
| Database: |
BASE |