Histopathology of Temporal Bone Fractures

Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030.
The Laryngoscope (Impact Factor: 2.14). 05/1994; 104(4):426-32. DOI: 10.1288/00005537-199404000-00006
Source: PubMed


Temporal bone fractures often cause loss of audiovestibular function. Those patients with bilateral profound sensorineural hearing losses secondary to temporal bone fractures become candidates for cochlear implantation. The authors present the histopathology of five temporal bone fractures in three patients, evaluating specifically the traumatic effects on the neural elements of the inner ear. Transverse fractures of the temporal bone result in severe loss of hair cells, ganglion cells, and other supporting cells in the inner ear. Occasionally labyrinthitis ossificans may occur as a consequence of trauma or infection. While longitudinal fractures do not violate the otic capsule, these same neural elements may be damaged by concussion.

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    • "sub-category in this respect: transverse fractures may lead to loss of spiral ganglion cells, infection, intracochlear haemorrhage followed by neo-osteogenesis leading to labyrinth ossifi cation. Cochlear obliteration may then inhibit a successful electrode insertion (Morgan et al, 1994; Colletti et al, 2004), followed by unsatisfactory results (Camilleri et al, 1999; Moore & Cheshire, 1999). Another drawback is the possible facial nerve stimulation due to current leaks through the low resistive fracture line (Camilleri et al, 1999). "
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    ABSTRACT: In this clinical note we discuss the indications, feasibility, and outcomes of binaural simultaneous cochlear implantation (CI) following bilateral transverse temporal bone (TB) fractures. A 41-year-old male, totally deaf after a bilateral TB fracture, underwent an audiological, electrophysiological, and imaging investigation in order to assess the integrity of the VIIIth cranial nerves. Five months later he received a simultaneous bilateral CI. Speech perception tests were conducted at different time points. A significant advantage by dichotic listening was observed since the beginning of the habilitation program. The patient achieved a 100% word and sentences recognition in quiet at 12 months. His listening skills in noisy conditions were improved by the use of two implants. A CI in TB fractures is feasible if the VIII nerve is intact and the cochlea is spared by the fracture rim. The early timing of the procedure probably contributed to its success by preventing cochlear fibrosis and ossification.
    International journal of audiology 10/2010; 49(10):788-93. DOI:10.3109/14992027.2010.497170 · 1.84 Impact Factor
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    The Laryngoscope 11/1999; 109(10):1674-8. DOI:10.1097/00005537-199910000-00023 · 2.14 Impact Factor
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