Fracture of the temporal bone in patients with traumatic brain injury

Summary

Introduction: The fractures in the temporal bone are lesions that are observed in patients with traumatic brain injury (TBI). The computed tomography of high-resolution (CT) allows evaluating the fracture and the complications.

Objective: Evaluate patients with TBI and temporal bone fracture.

Way of study: Retrospective study.

Method: Were evaluated 28 patients interned by TBI with clinical evidence and/or radiologic from temporal bone fractures.

Results: The age ranged from 3 to 75 years. The most affected side was the right side 50% (n = 14), left side 36% (n = 10) and both sides 14% (n = 4). The etiology of the trauma was the falling 25% (n = 7), accidents with motorcycles and bicycles 21% (n = 6), physical aggression 14% (n = 4), running over 11% (n = 3), fall of object 4% (n = 1) and other causes 25% (n = 7). The clinical signs were: Otorrhagia 78%, otalgia 11% (n = 3), otorrhea 7% (n = 2), facial paralysis 7% (n = 2) and hearing loss 7% (n = 2). The otoscopic findings: otorrhagia 57% (n = 16), laceration of external auditory canal 36% (n = 10), hemotympanum 11% (n = 3), normal 7% (n = 2) and Battle signal 7% (n = 2). The findings for CT of skull were: with no alterations 54% (n = 15) and temporal fracture 7% (n = 2) and the CT of temporal bones were: line of fracture 71% (n = 20), opacification of the mastoid 25% (n = 7), glenoid cavity air 14% (n = 1), dislocation of the ossicular chain 7% (n = 2) and veiling of the middle ear 4% (n = 1).

Conclusion: Patients with TBI must be submitted to the otorhinolaryngological evaluation and imaging, for the early diagnosis of the complications and treatment.

Resumo

Introdução: As fraturas de osso temporal são lesões que se observam em pacientes com traumatismo crânio-encefálico (TCE).A tomografia computadorizada de alta resolução (TC) permite avaliar a fratura e as complicações.

Objetivo: Avaliar pacientes com TCE e fratura de osso temporal.

Forma de estudo: Estudo retrospectivo.

Método: Foram avaliados 28 pacientes internados por TCE com evidência clínica e/ou radiológica de fratura de osso temporal.

Resultados: A faixa etária variou 3 a 75 anos O lado mais afetado foi o direito 50% (n = 14), esquerdo 36% (n = 10) e bilateral 14% (n = 4). A etiologia do trauma foi queda 25% (n = 7), acidentes com motocicletas e bicicletas 21% (n= 6), agressão física 14% (n= 4), atropelamento 11% (n = 3), queda de objeto 4% (n = 1) e outras causas 25% (n = 7). Os sinais clínicos foram: otorragia 78% (n = 22), otalgia 11% (n = 3), otorreia 7% (n = 2), paralisia facial 7% (n = 2) e hipoacusia 7% (n = 2). Os achados a otoscopia: otorragia 57% (n = 16), laceração de conduto auditivo externo 36% (n = 10), hemotímpano 11% (n = 3), normal 7% (n = 2) e sinal de Battle 7% (n = 2). Os achados à TC de crânio foram: sem alterações 54%(n = 15) e fratura de temporal 7% (n = 2) e na TC de ossos temporais foram: linha de fratura 71% (n = 20), velamento da mastoide 25% (n = 7), ar em cavidade glenóidea 14% (n = 4), luxação de cadeia ossicular 7% (n = 2) e velamento orelha média 4% (n = 1).

Conclusão: Pacientes com TCE devem ser submetidos à avaliação otorrinolaringológica e de imagem, para diagnóstico precoce das complicações e tratamento.

Keywords

temporal bone - fracture in the base of skull - computed tomography by X-ray

Palavras-chave

osso temporal - fratura da base do crânio - tomografia computadorizada por raios X

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