Temporal bone fracture: symptoms, manifestations and consequences of
Temporal bone fracture, the consequences of which are unpredictable, can dramatically change a person's life. Fears for the future, health will accompany the person to the end of life even at a favorable outcome.
After deformation of the temporal bone that occurs from a blow to the head, possible serious consequences. Injury dice with a certain probability diagnose radiographic examination of the skull. But the originality of the fracture of the temporal part is the presence of microscopic damage to the structures of the bone tissue, not visible on the radiograph. This kind of signs in the study of the temporal bone and can reveal histological analysis. If these methods of study is unable to determine the exact clinical presentation will help the computer tomography (CT).
Symptoms and signs
Pronounced injuries of this kind are impossible to ignore, because they are accompanied by many characteristic symptoms. In the region of the temporal bone is the auditory area of the cerebral hemispheres. The correlation with the gravitational unit, the external and internal auditory tube, and consequently its damage leads to loss of coordination, and acuity of hearing.
The most obvious symptom is a symptom Battle - in ecchymosis behind the ear, accompanied by bleeding from the external auditory canal. The bleeding proceeds from the cavity of the middle ear through the tympanic membrane deformed or damaged blood vessels of the Eustachian tube in the line of fracture.
Internal bleeding in the middle ear cavity leads to the appearance of hematomas and is manifested by formation of dark bruises on the skin and region of the tympanic membrane. In addition to the blood there are cases of leakage of cerebrospinal fluid from the ear canal. This proves the relationship between middle ear cavity and the subarachnoid area. Fractures can injure the Department, which leads to rupture of the eardrum.
The mucous membranes lining the auditory canal and tympanic cavity, are equipped with sensitive nerves and form the tympanic plexus. With the pinching of the conductive fibers of the nervous tissue in 20% of cases of possible paresis of the facial nerve and sensorineural hearing loss. Complete paralysis of the facial muscles may occur some time later. This symptom indicates that without damage to the auditory analyzer.
In the cavity of the middle ear are the 3 auditory ossicles. They form more or less the moving circuit from the drumof a membrane to the oval window of the inner ear across the tympanic cavity. Cochleas with a movable connection joint and several ligaments that provide bone conduction sound waves and mechanical transmission of sound vibrations. Contact damage in the places of articulation of the incus, the Malleus and stapes cause conductive hearing loss.
Fractures of the temporal bone pyramid
Fractures of the pyramid of the temporal bone are divided into several types. Transverse fracture is considered the most dangerous. Trauma is accompanied by loss of consciousness for hours or days. Damage to the area dense bone structure is called a direct mechanical force to the occipital or temporal area and is accompanied by paralysis of the facial nerve and waste. Symptoms of paralysis are detected, an hour later, despite the coma. Cochlear and vestibular function of the body is stopped completely or partially. The patient is unable to keep his balance and falls while walking. There is a risk of hematodinium. Some patients have cerebrospinal fluid (CSF) flows through the external auditory canal. In contact with the cerebrospinal fluid in the Eustachian tube, which communicates with the nasopharynx, the liquid flows from the nose. These signs are accompanied by dizziness rotational character, coupled with nausea and vomiting not associated with eating. In severe cases, the otolith apparatus and the cochlea of the inner ear are destroyed, leading to deafness. In partial lesions there is a hearing loss.
Doctors are the most common with longitudinal fractures of the temporal bone. This type of injury differs in the absence of displacement of bone fragments damaged. Localization - parieto-occipital area. The tympanic cavity short maze injured. In close proximity to the tympanic membrane, acquiring a cyanotic hue, while maintaining its integrity accumulate blood clots.
Atypical fracture is called because of the damaged thin plates, microcracks in the bone capsule of the labyrinth. Some patients have peripheral paresis of the facial nerve on the injured side. The activity of the vestibular apparatus, as a rule, is not disturbed. The consequences are manifested in the appearance of hearing loss and horizontal nystagmus. During sharp turns of the head increases the dizziness.
First aid for injury
When fracture of the temporal bone of the skull should immediately provideassistance to the victim. To do this, impose a sterile bandage on the injury and urgently deliver the victim in medical institution. You should not wash the bleeding wound and, moreover, to bury any medication, including painkillers. The patient's treatment often involves conservative therapy.
It is necessary to normalize all the vital systems of the body. Surgical operations are carried out after stabilization of the General condition and eliminate the pain. Symptoms of a concussion or brain injury must be excluded.
The acute phase is accompanied by preventive measures to prevent swelling of soft shells and parts of the brain. High probability of infection of wound surfaces of the lines of fractures, which lead to intractable inflammatory processes. To prevent re-infectious complications patients are prescribed a course of antibiotic therapy and dehydration treatment.
If the patient has a history of purulent otitis media or cause caused by trauma to the temporal bone, resorted to surgery method extended mastectomie. The need for this surgical procedures caused rather prophylactic purposes, because under a thin connective tissue film covering the infected segment of the middle ear, there is an active reproduction of pathogenic bacteria. Due to the unavailability of visual examination inflammation can cause purulent meningitis, latent for several years.
The consequences of injury
A person with a fracture of the temporal bone all my life, there is a danger of meningitis. Inflammation of the middle ear - otitis media - there is a risk of infection to the brain. Therefore, after discharge of the child to be wary whenever painful sensation in the organs of hearing. Required frequent consultation of the doctor-otolaryngologist. The probability of infection is eliminated by means of special graft filling the defect in trauma bone plates.
When you break the membrane, the blood flows from the external opening of the auditory tube. Subarachnoid hemorrhage constitute a threat to life. Even with the percolation of small volumes in brain structures increases the risk of symptoms of reactive meningitis. Striking the delicate structure of neurons and glia, he runs hard and fast, often with fatal outcome.
The inner ear, or labyrinth, is localized inside the pyramid of the temporal bone. Consists of vestibule, semicircular tubules and snails. Whendamage snails, despite the whole complex of rehabilitation measures, hearing cannot be restored. In injuries of the labyrinth of possible cases of spontaneous recovery, but not there are complications the functional activity of the vestibular apparatus. There is a loss of excitability and conductivity, leading to deafness and paralysis of the facial muscles.
To avoid complications, at the slightest suspicion on a trauma in the temporal area should be immediately referred to a specialist.
If the damage is in the pyramid of the temporal bone, the victim may lose not only hearing, but also life as a result of severe infectious complications.