Abstract
This retrospective study examined the etiology and treatment results for traumatic, conductive hearing loss in 22 patients who underwent surgery between 1998 and 2008 at Osaka Red Cross Hospital. All patients underwent computed tomography (CT) of the temporal bone preoperatively. The ear surgery comprised closure of the ruptured tympanic membranes and restoration of the sound-transmitting function of the ossicular chain. Their mean age was 30.3 years, and the average delay from injury until treatment was 6.0 years. Of the injuries due to foreign-body insertion, the most common cause was ear-pick injury. Incudostapedial disarticulation was the most common finding, which was diagnosed preoperatively using CT in seven cases and identified at surgery in 15 cases. Closure of the air–bone gap to within 10 and 20 dB was observed in 50.0 and 68.2% of the patients, respectively. The hearing threshold improved by 10 dB or more in 16 (72.7%) patients. If no improvement in hearing loss follows the absorption of hemotympanium or closure of an eardrum perforation, dislocation of the ossicular bones should be suspected. Ossicular reconstruction following trauma produces more stable and better hearing results, even after delayed treatment.
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Brodie HA, Thompson TC (1997) Management of complications from 820 temporal bone fractures. Am J Otol 18(2):188–197
Chen SS, Lao CB, Chiang JH, Chang CY, Lirng F, Guo WY, Shao KN, Teng MM, Chang T (1998) High resolution computed tomography of temporal bone fracture. Chin Med J (Taipei) 61(3):127–133
Griffin WL Jr (1979) A retrospective study of traumatic tympanic membrane perforation in a clinical practice. Laryngoscope 89:261–282
Hasso AN, Ledington JA (1988) Traumatic injuries of the temporal bone. Oto Clin North Am 21:295–316
Hato N, Okada M, Hakuba N, Hyodo M, Gyo K (2007) Repair of a malleus-handle fracture using calcium phosphate bone cement. Laryngoscope 117:361–363
Kobayashi T, Gyo K (2000) Earpick injury of the stapes. Am J Otol 21:340–343
Hough JV, Stuart WD (1968) Middle ear injuries in skull trauma. Laryngoscope 78(6):899–937
Lindeman P, Edström S, Granström G, Jacobsson S, von Sydow C, Westin T, Aberg B (1987) Acute traumatic tympanic membrane perforations. Cover or observation? Arch Otolaryngol Head Neck Surg 113(12):1285–1287
Meriot P, Veillon F, Garcia JF, Nonent M, Jezequel J, Bourjat P, Bellet M (1997) CT appearances of ossicular injuries. Radiographics 17:1445–1454
McGuirt WF, Stool SE (1992) Temporal bone fractures in children: a review with emphasis on long-term sequelae. Clin Pediatr (Phila) 31(1):12–18
Pedersen CB (1989) Traumatic middle ear lesions. Fracture of the malleus handle, aetiology, diagnosis and treatment. J Laryngol Otol 103(10):901–903
Podosin L, Fradis M (1975) Hearing loss after head injury. Arch Otolaryngol 101:15–18
Spector GJ, Pratt LL, Randall G (1973) A clinical study of delayed reconstruction in ossicular fractures. Laryngoscope 83(6):837–851
Suzuki M, Shigemi H, Mogi G (1999) The leaking labyrinthine lesion resulting from direct dorce through the auditory canal: report of five cases. Auris Nasus Larynx 26:29–32
Tos M (1971) Prognosis of hearing loss in temporal bone fracture. J Laryngol Otol 85:1147–1159
Vanderstock L, Vermeersch H, De Vel E (1983) Traumatic luxation of the stapes. J Laryngol Otol 97:533–537
Vital V, Psillas G, Vital I, Printza A, Triaridis S, Constantinidis J (2007) Ossicular necrosis following head injury. B-ENT 3(3):131–134
Wennmo A, Spandow O (1993) Fractures of the temporal bone–chain incongruencies. Am J Otolaryngol 14(1):38–42
Yetiser S, Hidir Y, Birkent H, Satar B, Durmaz A (2008) Traumatic ossicular dislocations: etiology and management. Am J Otolaryngol 29(1):31–36
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Hakuba, N., Iwanaga, M., Tanaka, S. et al. Ear-pick injury as a traumatic ossicular damage in Japan. Eur Arch Otorhinolaryngol 267, 1035–1039 (2010). https://doi.org/10.1007/s00405-009-1162-x
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DOI: https://doi.org/10.1007/s00405-009-1162-x