| Do contemporary temporal bone fracture classification systems reflect concurrent intracranial and cervical spine injuries? | |
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MedLine Citation:
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PMID: 21520104 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES/HYPOTHESIS: Temporal bone fractures (TBFs) are a frequent manifestation of head trauma. We investigated the prevalence of concurrent intracranial injuries (ICIs) and cervical spine injuries (CSIs) in a series of patients with TBFs and attempted to identify significant associations between current TBF classification systems and either ICI or CSI. STUDY DESIGN: Retrospective case series with chart review. METHODS: The records of all patients ≥18 years of age diagnosed with a basilar skull fracture, including TBF, at a level I trauma center from 2004 to 2009 were reviewed. Patient demographics, mechanism of injury, and Glasgow Coma Scale (GCS) scores were collected. Imaging studies were reviewed to classify TBF using the traditional longitudinal-transverse-mixed and otic capsule-sparing versus -involving systems and identify concurrent ICI and CSI. RESULTS: Of 1,279 patients, 202 (15.8%) met inclusion criteria. There were 160 (79.2%) males. Sixteen (7.9%) patients had bilateral TBFs. Falls (n = 66, 32.7%) represented the most common mechanism for TBF. Longitudinal (n = 96, 44.0%) and otic capsule-sparing (n = 209, 95.9%) fractures were the most prevalent subtypes. There were 184 (91.1%) patients who sustained ICI and 18 (8.9%) who demonstrated CSI. Longitudinal, transverse, mixed, otic capsule-sparing, or otic capsule-involving TBF subtypes had no statistically significant associations with mechanism of injury, GCS score, or concomitant ICI or CSI. CONCLUSIONS: More than 90% of patients sustaining TBF presented with concomitant ICI, and 9% sustained CSI. Current TBF classification systems do not correlate with these outcomes. A more sophisticated, multidisciplinary classification system encompassing radiographic and clinical findings may better predict neurologic, neuro-otologic, and skull base complications. |
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Authors:
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Gordon H Sun; Nael M Shoman; Ravi N Samy; Rebecca S Cornelius; Bernadette L Koch; Myles L Pensak |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Laryngoscope Volume: 121 ISSN: 1531-4995 ISO Abbreviation: Laryngoscope Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 929-32 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc. |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati/Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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