A comparison of temporal bone fracture classification systems

Authors:
Publisher website
Google Scholar
Abstract
Objectives:  To compare the traditional and otic capsule classification system of temporal bone fractures for clinical relevance.Design:  A retrospective review of all patients with a radiological diagnosis of a skull‐base fracture over a 5‐year period.Setting:  All patients were seen at Beaumont Hospital, the national tertiary referral centre for Neuro‐otology.Participants:  Patients with a clinical diagnosis of skull fracture were identified from the hospitals in patient enquiry (HIPE) database. Of 338 patients, 31 (9%) were identified as having a temporal bone fracture on high‐resolution CT scanning.Main outcome measures:  The rate and distribution of each major clinical complications within each classification system to establish if either one was more clinically useful.Results:  Fractures were classified as mixed in 14 (45%), longitudinal in 9 (29%) and horizontal in 8 (26%). Alternatively, 2 (7%) were otic capsule violating and 29 (93%) were otic capsule sparing. Seventeen patients (54.8%) sustained a hearing loss. Seven patients (23%) sustained a facial nerve injury. Four (13%) developed a cerebrospinal fluid (CSF) leak. Of all clinical findings only sensorineural hearing loss occurred significantly more often in the horizontal as opposed to the longitudinal group (P = 0.029) and in the otic violating as opposed to the otic sparing group (P = 0.013).Conclusions:  We acknowledge that the relatively small size of our cohort diminishes the statistical power of our conclusions. However, we found that the otic capsule‐based classification system was not significantly better than the traditional system in predicting the likelihood of sustaining specific injuries from fractures of the temporal bone.

This publication has 9 references indexed in Scilit: