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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 2 - Facial Plastic and Reconstructive Surgery

An Update on Temporal Bone Fracture Trends and Outcomes From a Level One Trauma Center

Monday, September 30, 2024
9:48 AM – 9:54 AM EDT
Location: MBCC, 232
Disclosure(s):
Emily R. Baker, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Aaron L. Zebolsky, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Travis Jonathan Clarke, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Paul M. Putnam, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anas A. Eid, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: This study was designed to provide an update on the trends of temporal bone fractures from a high-volume trauma center.

Methods: A retrospective analysis was performed on patients with temporal bone fractures at a safety net hospital over an 8-month period from August 2022 to March 2023. Presentation, management, and outcome data within three months of discharge were analyzed.

Results: Ninety patients were included over the 8-month study period. Mechanisms included motor vehicle crash (MVC; n=23, 25.5%), fall (n=23, 25.5%), gunshot wound (GSW; n=18, 20%), pedestrian struck (n=13, 14.4%), or other (n=13, 14.4%). Sixteen (17.8%) fractures involved the external auditory canal, 7/90 (7.8%) the otic capsule, and 6/90 (6.7%) the ossicular chain. Sixty-eight (75.5%) spared all of these structures. Injury to these structures was more likely with MVC or pedestrian struck injuries (36.1%) compared to other mechanisms (14.8%, P=0.019). Nineteen patients (21.1%) died and 12 (11.1%) were discharged without a comprehensive facial nerve exam. Seven of the remaining 60 (11.7%) had some degree of facial nerve weakness. Of these 7, 3 (42.9%) had facial weakness scoring between I-III on the House-Brackmann (HB) scale and 4 (57.1%) had HB scores between IV-VI. Five (71.4%) of these received systemic corticosteroids. None underwent decompression. One patient developed a cerebrospinal fluid leak requiring surgical repair. Patients who survived until discharge (24/71 (33.8%)) attended follow-up. Of these, 11 (45.8%) had hearing loss and 6 (25.0%) had facial nerve weakness. Three patients (50%) had HB scores of I-III and three (50%) had HB scores of IV-VI. Patients suffering GSWs tended to have higher rates of facial nerve weakness at follow-up (16.7%) compared to other mechanisms (4.2%; p=0.057).

Conclusions: A significant portion of patients with temporal bone fractures continue to suffer from hearing loss and facial weakness, particularly with penetrating injuries such as GSWs.

    Presenting Author(s)

  • Emily R. Baker, BS

    Research Fellow
    University of Tennessee Health Science Center
    Nashville, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Aaron L. Zebolsky, MD

    Resident
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Travis Jonathan Clarke, MD

    Resident
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • CH

    Christopher D. Hedden, BS

    Medical Student
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure information not submitted.

  • Paul M. Putnam, BS

    Medical Student
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Anas A. Eid, MD

    Division Director, Assistant Professor in Facial Plastic & Reconstructive Microsurgery
    University of Tennessee
    memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • RD

    Raj Dedhia, MD

    Chief, Division of Facial Plastic Surgery
    University of Tennessee Health Science Center
    Memphis, Tennessee, United States

    Disclosure information not submitted.