Long-Term Outcomes of Adult Temporal Bone Fractures With Hearing Loss: Results of a Multinational Database Analysis

IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2025-04-09 DOI:10.1002/lary.32140
Jason L. Steele, Heather J. Smith, Samira Takkoush, Jumah G. Ahmad, Zachary D. Urdang, Neil S. Patel, Richard K. Gurgel, Mana Espahbodi
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Abstract

Objective

Temporal bone fractures (TBFs) can result in long-term adverse outcomes including meningitis, facial nerve disorders (FNDs), and hearing loss (HL) that may require surgical intervention. This epidemiologic study aims to examine the sequelae of adult TBF with HL, including the utilization of cochlear implantation (CI), using data from a large, multinational database.

Methods

Using the TriNetX database, a retrospective cohort study was performed of adults (≥ 18 years) using ICD10 codes for other fractures of the base of the skull and hearing loss, an approximation of TBF with hearing loss. A control group of adults without TBF was used. Measured outcomes included meningitis, CI, FND, cerebrospinal fluid (CSF) leak, and labyrinthitis. Propensity score matching (1:1) was used for cohorts smaller than 33,333,333. Ninety-five percent of patient data used was from 2006 to 2023.

Results

Adults with TBF and HL (n = 34,878) had a greater risk of meningitis any time after TBF than those without TBF (n = 105,035,185) (RR: 6.65, 95% CI: 5.74–7.70). Labyrinthitis (RR: 3.56, 95% CI: 2.86–4.41), CSF leak (RR: 40.71, 95% CI: 37.91–43.71), and FND (RR: 12.08, 95% CI: 11.62–12.55) were more common after TBF. CI was more common after TBF (RR: 26.22, 95% CI: 22.12–31.07). Meningitis after TBF was associated with an increased risk of CSF leak (RR: 3.0, 95% CI: 1.52–5.93) compared to those without meningitis.

Conclusion

Adults who sustain TBFs resulting in HL have an increased risk of developing meningitis, labyrinthitis, CSF leak, and FND and are more likely to undergo CI for aural rehabilitation compared to a control cohort.

Level of Evidence

Level IV.

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听力损失的成人颞骨骨折的长期预后:多国数据库分析的结果。
目的:颞骨骨折(tbf)可导致长期不良后果,包括脑膜炎、面神经障碍(FNDs)和听力损失(HL),这些可能需要手术干预。本流行病学研究旨在研究成人TBF合并HL的后遗症,包括人工耳蜗植入(CI)的使用,使用来自大型跨国数据库的数据。方法:使用TriNetX数据库,对成人(≥18岁)进行回顾性队列研究,使用ICD10代码进行其他颅底骨折和听力损失,近似于TBF伴听力损失。对照组为无TBF的成年人。测量结果包括脑膜炎、CI、FND、脑脊液(CSF)泄漏和迷路炎。倾向评分匹配(1:1)用于小于33,333,333的队列。95%的患者数据来自2006年至2023年。结果:有TBF和HL的成人(n = 34,878)在TBF后的任何时间发生脑膜炎的风险高于无TBF的成人(n = 105,035,185) (RR: 6.65, 95% CI: 5.74-7.70)。迷路炎(RR: 3.56, 95% CI: 2.86 ~ 4.41)、脑脊液漏(RR: 40.71, 95% CI: 37.91 ~ 43.71)、FND (RR: 12.08, 95% CI: 11.62 ~ 12.55)在TBF术后更为常见。TBF后CI更常见(RR: 26.22, 95% CI: 22.12-31.07)。与未患脑膜炎的患者相比,TBF后脑膜炎与脑脊液泄漏风险增加相关(RR: 3.0, 95% CI: 1.52-5.93)。结论:与对照组相比,持续性脑外伤导致HL的成人患脑膜炎、迷路炎、脑脊液泄漏和FND的风险增加,并且更有可能接受CI进行听力康复。证据等级:四级。
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来源期刊
Laryngoscope
Laryngoscope 医学-耳鼻喉科学
CiteScore
6.50
自引率
7.70%
发文量
500
审稿时长
2-4 weeks
期刊介绍: The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects
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