A retrospective review is presented of 50 patients, with a basal skull frac
ture, who had radiological or clinical evidence of temporal bone involvemen
t. The study looks at the incidence of significant otological symptoms repo
rted during the admission and we review the subsequent patient management.
We propose that all patients presenting with a head injury, and one or more
of a number of symptoms characteristic of a temporal bone fracture, should
automatically have an otological assessment. This will facilitate the earl
y detection and subsequent follow up of potentially correctable middle ear
disorders. We review the literature to highlight the high incidence of comp
lications associated with these fractures.