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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Pediatric temporal bone fractures: Current trends and comparison of classification schemes
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Pediatric temporal bone fractures: Current trends and comparison of classification schemes

机译：小儿颞骨骨折：目前的趋势和分类方案的比较

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Objectives 1) Characterize the current presentation of pediatric temporal bone fractures, 2) compare two classification schemes for temporal bone fractures and illustrate complications in each fracture type. Design Retrospective medical record review. Setting Tertiary-care, academic children's hospital. Patients All children presenting from 1999 to 2009 with CT-proven temporal bone fracture and audiology examination with follow-up. Intervention All CT scans were reinterpreted by a dedicated head and neck radiologist. All fractures were characterized as otic capsule sparing (OCS) or otic capsule violating (OCV), as well as transverse (T) or longitudinal (L). Outcome CT findings, mechanisms of injury, sensorineural hearing loss (SNHL), conductive hearing loss (CHL), and facial nerve injury (FNI). Results Seventy-one children met inclusion criteria. Fifty-four (76%) children had longitudinal fractures versus 17 (24%) with transverse fractures. Sixty-four (90%) had OCS versus 7 (10%) with OCV. The otic capsule was involved in 7.4% of longitudinal fractures and 17.6% of transverse fractures. Eleven (15%) had facial weakness, 72% of whom had a visualized fracture through the facial nerve course. SNHL was detected in 14 (20%) patients and CHL in 17(23.9%). All patients with fractures classified as both transverse and OCV had SNHL. The OCS versus OCV and T versus L classification schemes were directly compared for statistical significance in predicting SNHL, CHL, and FNI using the Fisher's exact test. Both OCS/OCV and T/L were predictors of SNHL (P =.0025 and P =.0143, respectively), but the OCS/OCV scheme was more accurate. Neither classification significantly predicted CHL or FNI (P =.787 versus.825; P =.705 vs.755). Conclusions In this pediatric series, approximately 75% of the fractures are longitudinal and 25% are transverse. The otic capsule is spared in 90% and violated in 10%. Both OCS/OCV and L/T classification schemes predict SNHL, but the OCV/OCS scheme is more accurate in this prediction. Although the negative predictive value of the two schemes is similar, the positive predictive value is higher with the OCS/OCV system. The presence of conductive hearing loss and facial nerve symptoms was not predicted by either classification system.
机译：目标1）表征目前儿科颞骨骨折的表现，2）比较两种颞骨骨折分类方案，并说明每种骨折类型的并发症。设计回顾性病历审查。设置三级护理，学龄儿童医院。患者1999年至2009年期间接受CT证实的颞骨骨折和听力检查并随访的所有儿童。干预所有的CT扫描均由专门的头颈放射科医生重新解释。所有骨折均表现为耳囊保留（OCS）或耳囊侵犯（OCV），以及横向（T）或纵向（L）。结果CT表现，损伤机制，感觉神经性听力损失（SNHL），传导性听力损失（CHL）和面神经损伤（FNI）。结果71名儿童符合入选标准。五十四名儿童（76％）患有纵向骨折，而十七名儿童（24％）患有横向骨折。 64位（90％）患有OCS，而7位（10％）患有OCV。耳囊涉及7.4％的纵向骨折和17.6％的横向骨折。 11名（15％）的人脸无力，其中72％的人通过面神经横道可见骨折。在14（20％）患者中检测到SNHL，在17（23.9％）患者中检测到CHL。所有合并为横行和OCV骨折的患者均患有SNHL。使用Fisher精确检验直接比较了OCS对OCV和T对L的分类方案在预测SNHL，CHL和FNI方面的统计学意义。 OCS / OCV和T / L都是SNHL的预测因子（分别为P = .0025和P = .0143），但是OCS / OCV方案更为准确。两种分类均不能显着预测CHL或FNI（P = .787对0.825; P = .705对755）。结论在该儿科系列中，大约75％的骨折是纵向骨折，而25％的骨折是横向骨折。耳囊保留了90％，10％被侵犯。 OCS / OCV和L / T分类方案都可以预测SNHL，但是OCV / OCS方案在此预测中更准确。尽管两种方案的负预测值相似，但使用OCS / OCV系统的正预测值更高。两种分类系统均无法预测是否存在传导性听力损失和面神经症状。

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