• Amy Schell and Dennis Kitsko.
• UPMC Department of Otolaryngology, Pittsburgh, Pennsylvania, USA.
• Otolaryngol Head Neck Surg. 2016 Jan 1; 154 (1): 175-80.

ObjectiveTo characterize pediatric temporal bone trauma, focusing on audiometric outcomes.Study DesignCase series with chart review.SettingTertiary care children's hospital.Subjects And MethodsCases were reviewed of children (<18 years) presenting over a 3-year period with computed tomography-proven temporal bone fracture and audiology examination. All scans were read by a neuroradiologist and reviewed by a pediatric otolaryngologist. Demographics, fracture pattern, and audiometric data were recorded.ResultsFifty-eight patients (60 fractures) met inclusion criteria. The majority (93%) were otic capsule-sparing fractures. The types and severity of hearing loss were significantly different between the 2 fracture patterns. Based on pure-tone average, all otic capsule-violating fractures had abnormal initial audiograms; 75% of these losses were severe. Approximately half (54%) of otic capsule-sparing fractures had abnormal initial audiograms; a majority were mild losses (85%). All classifiable losses in otic capsule-violating cases were of mixed type, whereas the majority (75%) of losses in otic capsule-sparing cases were conductive. Regardless of classification, 72% of patients with otic capsule-sparing fractures and initially abnormal audiograms improved to normal levels at a mean of 48 days posttrauma; this increased to 83% when only conductive losses were considered.ConclusionsHearing loss type and severity differ in otic capsule-sparing and otic capsule-violating temporal bone fractures. A majority of children with otic capsule-sparing fractures and associated hearing loss improve to normal levels in about 6 weeks, especially if the original loss is classified as solely conductive. Children who do not improve within this time frame may warrant early investigation into surgically correctable causes.© American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

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