Acute temporal bone trauma: utility of high-resolution computed tomography.
OBJECTIVE
To determine the clinical utility of high-resolution computed tomography (HRCT) for temporal bone trauma evaluation and management.


METHODS
Retrospective review.


METHODS
Level I trauma center.


METHODS
Patients (n = 105) with evidence of temporal bone trauma.


METHODS
Statistically significant associations between HRCT, clinical, audiometric, and head CT findings, and management decisions; role of HRCT in management decisions.


RESULTS
Statistical analysis demonstrated poor association between specific clinical and HRCT findings, and between HRCT findings and management decisions. The HRCT complemented decision making in 10% of cases and revealed asymptomatic carotid canal fractures in 9% of cases.


CONCLUSIONS
Routine HRCT yields minimal clinical utility. Selective use of HRCT may complement decision making, but patient management is predominantly influenced by other factors. Although angiography was performed in cases of asymptomatic carotid canal fractures, no clinical utility for this practice was demonstrated. An algorithm for temporal bone trauma evaluation and management is presented.
Kahn
J B
JB
Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.
Stewart
M G
MG
Diaz-Marchan
P J
PJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004427:Ear Diseases / Q000453:epidemiology / Q000209:etiology; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013701:Temporal Bone / Q000000981:diagnostic imaging* / Q000293:injuries*; D014057:Tomography, X-Ray Computed