TY - JOUR
T1 - Temporal Bone Gunshot Wounds
T2 - A Multi-institutional Retrospective Study
AU - Demirjian, Natalie L.
AU - Grande, David
AU - Imbery, Terence E.
AU - Muelleman, Thomas
AU - Walsh, Erika M.
AU - Wick, Cameron C.
AU - Dewyer, Nicholas A.
N1 - Publisher Copyright:
© 2024, Otology & Neurotology, Inc.
PY - 2024
Y1 - 2024
N2 - Objective: To investigate management practices and outcomes in a retrospective cohort of patients who have sustained temporal bone gunshot wounds (TBGSW). Study Design: Retrospective chart review. Setting: Five participating hospitals. Patients: Twenty-two patients met inclusion criteria: experienced a TBGSW, survived ≥30 days following the injury, and were evaluated and managed by a neurotologist between 2019 and 2023. Interventions: No specific interventions were performed for the purposes of this study. Main Outcome Measure(s): Characteristics, evaluation, management, and outcomes of TBGSW survivors. Results: Patients were found to have a mean age of 33 ± 18 years and were predominantly male (18/22, 81.8%). Majority of patients (17/22, 77.3%) had mastoid injury. Most patients (14/22, 63.6%) had some evidence for vascular injury, most frequently the internal carotid artery (9/22, 40.9%). Almost three-quarters (17/22, 77.3%) of patients had clinical exam findings of facial nerve injury, which was the most common indication for surgery. Otologic surgery was performed in 72.7% (16/22), with delayed adverse events most commonly including cholesteatoma and external auditory canal stenosis. Though evidence for hearing impairment was clinically present in at least 15 of 22 patients (68.2%), hearing rehabilitation was pursued in only two patients. Conclusion: With increasing numbers of TBGSW survivors, there is a growing need for practicing neurotologists to be familiar with the wide spectrum of injury patterns and possible complications to inform clinical management in these patients. Early neurotologic assessment and follow-up beyond the acute period is crucial to minimize morbidity in this high-risk cohort.
AB - Objective: To investigate management practices and outcomes in a retrospective cohort of patients who have sustained temporal bone gunshot wounds (TBGSW). Study Design: Retrospective chart review. Setting: Five participating hospitals. Patients: Twenty-two patients met inclusion criteria: experienced a TBGSW, survived ≥30 days following the injury, and were evaluated and managed by a neurotologist between 2019 and 2023. Interventions: No specific interventions were performed for the purposes of this study. Main Outcome Measure(s): Characteristics, evaluation, management, and outcomes of TBGSW survivors. Results: Patients were found to have a mean age of 33 ± 18 years and were predominantly male (18/22, 81.8%). Majority of patients (17/22, 77.3%) had mastoid injury. Most patients (14/22, 63.6%) had some evidence for vascular injury, most frequently the internal carotid artery (9/22, 40.9%). Almost three-quarters (17/22, 77.3%) of patients had clinical exam findings of facial nerve injury, which was the most common indication for surgery. Otologic surgery was performed in 72.7% (16/22), with delayed adverse events most commonly including cholesteatoma and external auditory canal stenosis. Though evidence for hearing impairment was clinically present in at least 15 of 22 patients (68.2%), hearing rehabilitation was pursued in only two patients. Conclusion: With increasing numbers of TBGSW survivors, there is a growing need for practicing neurotologists to be familiar with the wide spectrum of injury patterns and possible complications to inform clinical management in these patients. Early neurotologic assessment and follow-up beyond the acute period is crucial to minimize morbidity in this high-risk cohort.
KW - Ballistic injury
KW - Facial nerve paralysis
KW - Gunshot wounds
KW - Temporal bone
KW - Temporal bone fracture—Trauma
UR - http://www.scopus.com/inward/record.url?scp=85209214533&partnerID=8YFLogxK
U2 - 10.1097/MAO.0000000000004351
DO - 10.1097/MAO.0000000000004351
M3 - Article
C2 - 39511737
AN - SCOPUS:85209214533
SN - 1531-7129
JO - Otology and Neurotology
JF - Otology and Neurotology
M1 - 10.1097/MAO.0000000000004351
ER -