Temporal bone fractures in children – are we doing enough?
Reviewed by Madhup K Chaurasia

This is a retrospective study which assessed clinical presentation and prognosis in 91 children under the age of 18 who developed temporal bone fractures from trauma, the commonest of which was falls from heights followed by motor vehicle accident. The common presentations – ranging from hematoma, through to concussion, nausea and vomiting, otorrhoea, vertigo, CSF leakage, facial nerve injury and others were compared in children who had otic capsule violation (OCV) with the group in which this was spared (OCS). More children with OCV had these presentations and symptoms compared with those with OCS, except, strangely enough, for amnesia, dizziness and confusion. All children with OCV had sensorineural hearing loss (50%) and mixed hearing loss (50%) whereas 78% of children with OCS were spared of any hearing deficit. CSF leakage was successfully resolved with use of acetazolamide. Facial paralysis recovered in two of the three affected. Interestingly, early audiological assessment was done in only 36% of these children, possibly due to accompanying injuries predominating. Three children with OCS had SNHL which could have been due to damage to the cochlea, not featured in imaging. The authors strongly emphasise that early audiological assessment facilitates better prognosis and the need for cochlear implant can be identified and fulfilled. Other studies quoted also show delayed or no audiological assessment which emerges as a serious concern from this publication.

Pediatric temporal bone fractures: a single centre experience.
Algouneh A, Madou E, Gandhi K,et al.
J LARYNGOLOGY OTOL
2025;139(2):113–17.