Clinical study of condylar fracture with external auditory canal fracture in 34 patients

doi:10.19438/j.cjoms.2020.04.015

Abstract

Abstract: PURPOSE: To investigate the association between condylar fracture and external auditory canal fracture and the necessity of simultaneous operation. METHODS: A total of 230 cases with 320 condylar fractures were divided into 4 clinical types according to the location of fracture line: sagittal fracture of the condyle (type Ⅰ), intracapsular condylar fracture (type Ⅱ), condylar neck fracture (type Ⅲ) and condylar base fracture (type Ⅳ). Chi-square test of SPSS 20.0 software package was used to compare the distribution of ipsilateral external auditory canal fracture between different types of condylar fracture. The prognosis of condylar and external auditory canal fractures were also compared. RESULTS: Forty-six sides in 34 patients were found with condylar fracture combined with external auditory canal fracture, including 12 sides, 16 sides, 7 sides and 5 sides in type I to type Ⅳ of condylar fractures, and 6 sides without condylar fracture. The incidence of type Ⅲ condylar fracture combined with ipsilateral external auditory canal fracture was significantly lower than other three types(P<0.05). Type I condylar fracture was found with significantly higher incidence of external auditory canal fracture compared to type Ⅳ(P<0.05). No significant difference was observed between any other two types. Thirty sides in 22 patients were followed up for 6 months after injury. Among these followed-up patients, eight sides in 5 patients without cerebrospinal leakage were treated with operations simultaneously. No traumatic stenosis and atresia of the external auditory canal and no decrease of hearing within 6 months was found after operation. In another 17 patients, twenty-two sides of the external auditory canal showed stenosis of varying degrees. Furthermore, among these 17 patients, five sides in 4 patients had severe hearing impairment (all of them were diagnosed as comminuted fractures of the external auditory canal). CONCLUSIONS: The incidence of external auditory canal fracture was observed lower in condylar neck fracture compared to sagittal condylar fracture. Treatment of maxillofacial fractures should be accompanied by early treatment of external auditory canal fractures, and active prevention of external auditory canal stenosis, hearing loss and other complications are necessary.

Key words: Condylar fracture, External auditory canal fracture, Cerebrospinal fluid leakage

CLC Number:

R782.3

JIANG Yan, WEN Yue-jin, JIANG Can-yang, HUANG Jian-ping, SHI Bin, ZHU Xiao-feng, HUANG Li, LIN Li-song. Clinical study of condylar fracture with external auditory canal fracture in 34 patients[J]. China Journal of Oral and Maxillofacial Surgery, 2020, 18(4): 361-364.

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