title: Audiometric Outcomes in Pediatric Temporal Bone Trauma.
abstract: OBJECTIVE
  To characterize pediatric temporal bone trauma, focusing on audiometric outcomes.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Cases 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.
  
  
  RESULTS
  Fifty-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.
  
  
  CONCLUSIONS
  Hearing 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.
authors.affiliation: UPMC Department of Otolaryngology, Pittsburgh, Pennsylvania, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Schell
authors.affiliation: UPMC Department of Otolaryngology, Pittsburgh, Pennsylvania, USA Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA Dennis.Kitsko@chp.edu.
authors.forename: Dennis
authors.initials: D
authors.lastname: Kitsko
mesh_terms: D000293:Adolescent; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012887:Skull Fractures / Q000150:complications*; D013701:Temporal Bone / Q000293:injuries*
keywords: conductive hearing loss; mixed hearing loss; otic capsule–sparing; otic capsule–violating; sensorineural hearing loss; temporal bone fracture