Correlation between injury characteristics and temporal bone pneumatization in 42 patients with facial paralysis following temporal bone fractures
Gao Wei
Zi Dingjing
Yuan Hao
Liu Chengcheng
Huang Huang
Ma Pengwei
Yang Jing
Ding Xuerui
Jing Yong
Lu Lianjun
Abstract：Objective To analyze the degree of temporal bone pneumatization among various injury charac-teristics in patients with facial paralysis following temporal bone fractures,and to explore the potential influence of pneumatization on these injury characteristics.Methods A retrospective analysis was conducted on 42 patients(36 males,6 females;mean age 36.2 years,ranging 16-64 years)with facial paralysis caused by temporal bone fractures who were treated at the Second Affiliated Hospital of Air Force Medical University between Jun.2015 and Jun.2024.The degree of temporal bone pneumatization was assessed using high-resolution temporal bone CT.Differences in pneumatization were compared across four injury characteristics:ossicular chain dislocation(n=27),elevated bone-conduction thresholds(n=12),facial nerve injury segments(geniculate ganglion:n=23;horizontal segment:n=16;vertical segment:n=3),and bony fragment compression of the facial nerve(n=11).Results Patients with ossicular chain dislocation had a lower rate of patients with≥grade Ⅲ pneumatization in the pericarotid air cells(25.9％,7/27),compared with those without dislocation(60.0％,9/15,P=0.036).Infralabyrinthine pneumatiza-tion≥grade Ⅲ was absent in the dislocation group(0),but present in 33.3％of the non-dislocation group(5/15,P=0.023).Among patients with elevated bone-conduction thresholds,the proportion of patients with≥grade Ⅲpericarotid pneumatization(16.7％,2/12)was much lower than that among those without threshold elevation(46.7％,14/30,P=0.016).Similarly,infralabyrinthine pneumatization≥grade Ⅲ was absent in the threshold ele-vation group(0)but present in 16.7％of the non-elevated group(5/30,P=0.025).No significant pneumatization differences were observed between patients with or without geniculate ganglion injury across the retrosigmoid,petrous apex,infralabyrinthine,or perigeniculate regions(all P>0.05).However,perigeniculate pneumatization≥grade ⅢI was significantly more frequent in patients with facial nerve compression by bony fragments(81.8％,9/11),com-pared with those without compression(32.3％,10/31,P=0.013).Conclusion Higher pneumatization of the peri-carotid and infralabyrinthine air cells may protect against ossicular chain dislocation and hearing threshold elevation,whereas increased perigeniculate pneumatization may predispose to fracture fragment compression of the facial nerve.
Keywords：Temporal bone fracturesFacial paralysisPneumatization
Publication Date：2025-11-15
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：7( 825-831 )