Unusual injury with mastoid fracture

The direct and indirect application of force can lead to isolated fractures in the area of ??the temporal bone. Very often these injuries arise in the context of traffic accidents, Brutality, falls or bicycle accidents. In Europe, injuries from projectiles rather to play a Subordinate role.

Case presentation A 43-year-old patient presented to us via the ZNA. During deforesting, a metal part from a torn tension belt befall the patient behind the left ear. Clinically, there was a deep soft tissue injury with an exposed, blown mastoid. Another laceration ran through the auricula left. Otoscopically, there was an intact ear canal with an intact, non-irritating eardrum without any signs of hematotympanum. There was no otoliquorrhae. The facial nerve was intact.

The CT temporal bone showed an isolated mastoid fracture. The middle and inner ear structures appeared intact. An exploration was carried out under intubation anesthesia, in which case bone fragments were removed from the mastoid, and after a Redon drainage had been inserted, the wound was closed.

Discussion Fractures in the area of ??the temporal bone can be divided into longitudinal and transverse fractures or mixed fractures according to the effects of trauma. Facial paralysis or injury of the middle and inner ear structures with deafness are possible. Heavy bleeding from injuries of larger blood vessels has also been described. The treatment strategy depends on the severity of the injury. Acute bleeding or facial paralysis requires immediate surgical intervention. Here the nerve should be explored with decompression.

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Publication History

Article published online:
13 May 2021