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<p>Temporal bone fractures due to gunshot wounds are uncommon but present unique challenges for management.&#xa0;The aim of this study was to report patient outcomes and offer treatment recommendations based on a single institution’s experience. A retrospective chart review was conducted of patients who sustained temporal bone fractures from ballistic injuries and were treated at the University of Maryland Shock Trauma Center between 2018 and 2024. Sixteen patients with 18 temporal bone fractures were included. Mean age was 30.5&#xa0;years (SD 9.9). Most were male (10 [62.5%]). The otic capsule was involved in three (19%) patients. Most were intubated at time of initial evaluation (11, [69%]). Seven (39%) patients had HB grade I-II, and three (17%) had HB III-IV. Of four patients with HB grade V-VI, one (25%) recovered to HB I with medical management and two (50%) underwent facial nerve reanimation procedures. External auditory canal injury (3 [19%]) and CSF leak (4 [25%]) were indications for either transcanal or transmastoid repair. Four (25%) patients pursued hearing rehabilitation. Otolaryngologic sequelae of gunshot wounds to the temporal bone are heterogenous, necessitating individualized management approaches. Despite appropriate intervention, outcomes after complete facial nerve paralysis remain poor. Hearing rehabilitation is often underutilized. Close long-term follow-up is essential to address and optimize delayed complications.</p>

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Management of Temporal Bone Fractures in Patients Surviving Ballistic Injuries

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Cailin Cruess,
  • Christopher Z. Wen,
  • Pharibe Pope,
  • Manasi Prashant,
  • Bashar Hassan,
  • Michael P. Grant,
  • Kalpesh T. Vakharia,
  • Adam C. Kaufman,
  • Natalie S. Justicz

摘要

Temporal bone fractures due to gunshot wounds are uncommon but present unique challenges for management. The aim of this study was to report patient outcomes and offer treatment recommendations based on a single institution’s experience. A retrospective chart review was conducted of patients who sustained temporal bone fractures from ballistic injuries and were treated at the University of Maryland Shock Trauma Center between 2018 and 2024. Sixteen patients with 18 temporal bone fractures were included. Mean age was 30.5 years (SD 9.9). Most were male (10 [62.5%]). The otic capsule was involved in three (19%) patients. Most were intubated at time of initial evaluation (11, [69%]). Seven (39%) patients had HB grade I-II, and three (17%) had HB III-IV. Of four patients with HB grade V-VI, one (25%) recovered to HB I with medical management and two (50%) underwent facial nerve reanimation procedures. External auditory canal injury (3 [19%]) and CSF leak (4 [25%]) were indications for either transcanal or transmastoid repair. Four (25%) patients pursued hearing rehabilitation. Otolaryngologic sequelae of gunshot wounds to the temporal bone are heterogenous, necessitating individualized management approaches. Despite appropriate intervention, outcomes after complete facial nerve paralysis remain poor. Hearing rehabilitation is often underutilized. Close long-term follow-up is essential to address and optimize delayed complications.