■为了评估枪伤(GSW)对颞骨(TB)的听力学后果,并将听力结果与颞骨附近的神经和血管损伤相关联。
■回顾性病例系列。
■大学一级创伤中心。
■回顾性回顾了35例结核弹道损伤幸存的患者,2012年至2021年。主要结果是听力学结果。人口统计,伴随的伤害,CT,并对干预措施进行了审查。
■平均年龄为30.7岁;80%为男性。17例患者(48.6%)接受了听力学测试。平均纯音平均值(PTA)为75±35dB,骨线平均值41±26dB,和言语辨别得分(SDS)60±43%。19例(54.3%)出现面神经损伤(FNI),他们更有可能展示SNHL,特别是anacusis,尽管他们的平均PTA和SDS与没有统计学差异(分别为P=.30和.47)。感觉神经性丧失者的影像学检查(SNHL,6/17)显示耳囊破裂骨折(n=2),气动迷宫(n=2),颅内出血(n=3)。那些混合损失(6/17)显示保留耳囊的骨折(n=6),EAC损伤(n=5),听骨不连续(n=2),颅内出血(n=4)。仅乳突尖端骨折的两个听力图正常。伴随的CSF泄漏不能预测听力结果,脊髓损伤,血管损伤,颅神经病,或者创伤性脑损伤.
■所有类型的听力损失,感觉神经性,混合和正常-可以在TB弹道损伤后看到。严重到足以破坏面神经的创伤更有可能引起失音。然而,都应该得到正式评估,由于弹道损伤并发神经或血管损伤不一定与较差的听力学结果相关,而轻微骨折的患者可能表现出损失。
UNASSIGNED: To evaluate audiologic consequences of gunshot wounds (GSWs) to the temporal bone (TB), and to correlate hearing outcomes with neurologic and vascular injuries adjacent to the temporal bone.
UNASSIGNED: Retrospective case series.
UNASSIGNED: University-based level-one trauma center.
UNASSIGNED: Retrospective review of 35 patients surviving TB ballistic injury, 2012 to 2021. Main outcomes were audiologic results. Demographics, concomitant injuries, CT, and interventions were reviewed.
UNASSIGNED: Mean age was 30.7 years; 80% male. Seventeen patients (48.6%) underwent audiologic testing. Mean pure tone average (PTA) was 75 ± 35 dB, bone line average 41 ± 26 dB, and speech discrimination score (SDS) 60 ± 43%. Nineteen (54.3%) demonstrated facial nerve injury (FNI), who were more likely to show SNHL especially anacusis, though their mean PTA and SDS were not statistically different from those without (P = .30 and .47, respectively). Radiographic review of those with sensorineural loss (SNHL, 6/17) revealed otic capsule-disrupting fracture (n = 2), pneumolabyrinth (n = 2), intracranial hemorrhage (n = 3). Those with mixed loss (6/17) showed otic capsule-sparing fracture (n = 6), EAC injury (n = 5), ossicular discontinuity (n = 2), and intracranial hemorrhage (n = 4). Two with mastoid tip fractures alone had normal audiograms. Audiometric outcomes were not predicted by concomitant CSF leak, spinal injuries, vascular injuries, cranial neuropathies, or traumatic brain injury.
UNASSIGNED: All patterns of hearing loss-conductive, sensorineural, mixed and normal-may be seen following TB ballistic injuries. Trauma severe enough to disrupt the facial nerve is more likely to cause anacusis. However, all should be formally evaluated, since ballistic injuries complicated by neurologic or vascular damage do not necessarily correlate with worse audiologic outcomes, while patients with minimal fractures may demonstrate losses.