TEMPORAL BONE-FRACTURES

The diagnosis and monitoring of patients presenting to an emergency de partment with blunt temporal bone fracture and complications requiring acute management were reviewed for a four-month period, Of 104 trauma patients with closed head injury, 15 patients were diagnosed with tem poral bone fracture, 12 of whom survived their injuries. Four patients developed cerebrospinal fluid (CSF) otorrhea and two patients develop ed facial nerve paralysis; all patients had resolution of complication s with conservative management. Significant shortcomings in the initia l evaluation and monitoring of patients with temporal bone fracture we re identified. Specific and thorough facial nerve examinations were no t initially conducted on temporal bone fracture patients and subsequen t inpatient monitoring for facial nerve paralysis and CSF otorrhea was incomplete. The outcome of temporal bone fracture is discussed. This article reminds the emergency physician of the importance of initial d iagnosis and documentation of temporal bone fractures. ((C) 1995 by W. B. Saunders Company)