The Journal of International
Advanced Otology
Original Article

Contralateral Hearing Loss in Temporal Bone Fractures: A Potential Association with Combined Intracranial Injury

1.

Department of Neurosurgery, Korea University College of Medicine, Republic of Korea

2.

Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Republic of Korea

3.

Jenks Vestibular Physiology Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts

J Int Adv Otol 2024; 20: 210-215
DOI: 10.5152/iao.2024.22989
Read: 597 Downloads: 227 Published: 23 May 2024

BACKGROUND: Temporal bone (TB) fractures are frequently accompanied by intracranial injury. This study aimed to analyze combined intracranial injuries in relation to functional changes in the inner ear, including those of the contralateral ear, in patients with TB fractures.

METHODS: Ninety-four patients (mean age: 35.6 ± 18.7 years, M : F=67 : 27) diagnosed with unilateral TB fracture were included. Bone conduction (BC) threshold, word recognition score (WRS), and changes in vestibular function were compared based on intracranial injuries, focusing on the contralateral side.

RESULTS: Various types of intracranial injuries were observed (67.9%). Among these, a significant association between traumatic brain injury (TBI) and otic capsule-violating fractures was noted. The BC threshold on the fractured side significantly deteriorated in patients with TBI. Additionally, a significantly worse BC threshold was confirmed on the contralateral side in patients with TBI, intracranial hemorrhage (ICH), and contrecoup injury. The follow-up BC threshold did not improve or differ, regardless of high-dose steroid administration. The initial WRS and canal paresis in the bithermal caloric test were not significantly different in the presence of each intracranial injury. Concurrent fluctuations in the pressure of the cerebrospinal fluid space and perilymphatic space were speculated to be the potential underlying mechanisms.

CONCLUSION: A significantly worse BC threshold was confirmed on the contralateral side of patients with TBI, contrecoup injury, ICH, and on fracture sides of patients with TBI.

Cite this article as: Kim B, Song I, Choi J, Chan Rah Y. Contralateral hearing loss in temporal bone fractures: A potential association with combined intracranial injury. J Int Adv Otol. 2024;20(3):210-215.

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