Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Research Article Volume 4 Issue 3

Mastoid Pneumatization and its Influence in Temporal Bone Fractures in Head Trauma Patients

Jose L Treviño-Gonzalez1*, Guillermo E Ortega-Fanjon1, Karla M Santos-Santillana1, German A Soto-Galindo1, Yehuda J Garcia- Gutierrez2 and Natalia Villarreal-del Bosque2

1Otolaryngology and Head and Neck Surgery Division, School of Medicine and University Hospital “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
2Radiology Division, School of Medicine and University Hospital “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico

*Corresponding Author: Jose L Treviño-Gonzalez, Otolaryngology and Head and Neck Surgery Division, School of Medicine and University Hospital “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.

Received: January 14, 2022; Published: February 28, 2022

What we know?

Objective:Temporal bone fractures secondary to head trauma is a frequent cause of otorhinolaryngological consult with a reported incidence of 14-22%. The external pressure inflicted on the temporal bone produces a fracture line that commonly follows anatomically vulnerable paths such as suture lines and air cells damaging vital structures harbored within the temporal bone. Multiple studies have demonstrated a protective function of other pneumatized cranial spaces; however, the role of mastoid air cells as a shock observer with protective qualities has lacking evidence. This study aims to correlate the previous findings and determine if temporal bone pneumatization is associated with the severity of temporal bone fractures.

Patients and Methods:We conducted a retrospective study of randomly selected consecutive patients admitted to the University Hospital “Dr Jose E. Gonzalez” from March 2020 to March 2021.

Results:A total of 96 HCT were evaluated. The patients mean age was 36.1 ± 16.1. A total of 91.4% (n = 85) patients were male. The most common type of pneumatization pattern of the temporal bone was type 3 (32.7%, n = 34). Mastoid and tympanic tegmen were involved in 26.9% of cases (n = 28). Fracture extension through the mastoid and tympani tegmen was observed in 46.7% and 26.7% of patients with type 1 pneumatization, respectively. A statistical difference was observed in tegmen tympani involvement between pneumatization groups (p = 0.0467).

Conclusion:In our study, an extensive pneumatization of the temporal bone was associated with a decreased fracture involvement of mastoid and tympani tegmen.

Keywords:Temporal Bone; Skull Fractures; Anatomic Variation; Traumatic Brain Injury; Ear

References

  1. Brodie HA., et al. “Management of complications from 820 temporal bone fractures”. The American Journal of Otology2 (1997): 188-197.
  2. , et al. “Skull base fractures and their complications”. Neuroimaging Clinics of North America 24.3 (2014): 439-465.
  3. Magnuson B. “Functions of the mastoid cell system: auto-regulation of temperature and gas pressure”. The Journal of Laryngology and Otology2 (2003): 99-103.
  4. Kellman RM., et al. “The paranasal sinuses as a protective crumple zone for the orbit”. The Laryngoscope 9 (2009): 1682-1690.
  5. Celiker M., et al. “Controversy about the protective role of volume in the frontal sinus after severe head trauma: larger sinus equates with higher risk of death”. The British Journal of Oral and Maxillofacial Surgery 3 (2020): 314-318.
  6. Kang TK., et al. “The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture”. PloS One5 (2019): e0217682.
  7. Han SJ., et al. “Classification of temporal bone pneumatization based on sigmoid sinus using computed tomography”. Clinical Radiology11 (2007): 1110-1118.
  8. Gurdjian ES., et al. “Deformations of the skull in head injury studied by the stresscoat technique, quantitative determinations”. Surgery, Gynecology and Obstetrics 83 (1946): 219-339.
  9. Ghorayeb B Y and J W Yeakley. “Temporal bone fractures: longitudinal or oblique? The case for oblique temporal bone fractures”. The Laryngoscope2 (1992): 129-134.
  10. Little SC., et al. “Radiographic classification of temporal bone fractures: clinical predictability using a new system”. Archives of Otorhinolaryngology-Head and Neck Surgery 12 (2006): 1300-1304.
  11. Johnson Freedom., et al. “Temporal bone fracture: evaluation and management in the modern era”. Otolaryngologic clinics of North America3 (2008): 597-618.
  12. Kanona H., et al. “A large case series of temporal bone fractures at a UK major trauma centre with an evidence-based management protocol”. The Journal of Laryngology and Otology3 (2020): 205-212.
  13. Jadhav AB., et al. “Classification and volumetric analysis of temporal bone pneumatization using cone beam computed tomography”. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology3 (2014): 376-384.
  14. Bronoosh P., et al. “Temporal bone pneumatisation: a computed tomography study of pneumatized articular tubercle”. Clinical Radiology2 (2014): 151-156.
  15. Dexian Tan A., et al. “Classification of Temporal Bone Pneumatization on High-Resolution Computed Tomography: Prevalence Patterns and Implications”. Otolaryngology--head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery4 (2018): 743-749.
  16. Kurihara YY., et al. “Temporal Bone Trauma: Typical CT and MRI Appearances and Important Points for Evaluation”. RadioGraphics4 (2020): 1148-1162.
  17. Montava M., et al. “Temporal bone fractures: sequelae and their impact on quality of life”. American Journal of Otolaryngology3 (2015): 364-370.

Citation

Citation: Jose L Treviño-Gonzalez., et al. “Mastoid Pneumatization and its Influence in Temporal Bone Fractures in Head Trauma Patients". ActaActa Scientific Otolaryngology 4.3 (2022): 42-48.

Copyright

Copyright: © 2022 Jose L Treviño-Gonzalez., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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