Surgical management and prognostic analysis of ear complications following temporal bone fractures

Wei Hao; Jiang Yue; Gao Xia; Qian Xiaoyun

doi:10.3969/j.issn.1009-4237.2025.11.003

Abstract：Objective To observe the short-and long-term efficacy of surgical treatment for ear-related complications of temporal bone fractures(TBF).Methods This study retrospectively analyzed clinical data of 26 TBF patients with ear complications who received surgical treatment at our department from Apr.2018 to Apr.2025.There were 17 males and 9 females,with the age ranging from 14 to 61 years(average age:35.4 years).The injury causes included 14 cases of falls,9 road traffic accidents,2 falls from heights,and 1 blast injury.Ear-related complications included hearing loss in 26 cases,facial nerve palsy in 8 cases,tinnitus in 12 cases,cerebrospinal fluid otorrhea in 1 case,and vestibular dysfunction in 2 cases.The TBF types,complication distributions,treatment plans,and short-and long-term prognostic outcomes were collected and analyzed.Results Among the 26 patients,there were 13 cases of longitudinal fractures,4 transverse fractures,4 mixed fractures,and 5 unclassifiable.Regarding the otic capsule involvement,23 cases were otic capsule sparing and 3 were otic capsule violating.All the included pa-tients were treated surgically,i.e.,tympanotomy with ossicular chain reconstruction was performed in 19 cases,with outcomes categorized as marked effectiveness in 11 cases,effectiveness in 4 cases,and ineffectiveness in 4 cases;concurrent facial nerve decompression was performed in 2 cases,both of which achieved postoperative recovery to House-Brackmann grade Ⅱ;and cochlear implantation was successfully performed in 7 cases.All the patients were discharged uneventfully.Conclusion The predominant types of TBF among the enrolled patients were longitudinal fractures and otic capsule sparing.Early identification and comprehensive assessment of TBF types and ear-related complications are crucial for clinical diagnosis and treatment.For different types of TBF complications,correct and reasonable surgical strategies are key to improving the prognosis and efficacy.