Abstract
Amaç: Dış
kulak yolu (DKY) maksillofasiyal travmaların (MFT) muayenesinde sıklıkla gözden
kaçırılan bir bölgedir. DKY’nin anterior ve inferior duvarları, temporal
kemiğin timpanik parçasından meydana gelir. Timpanik parça temporomandibular
eklem ile yakın ilişkidedir. Kondil DKY’e doğru kuvvet uyguladığında, kondilin
posterior ve anteromedial dislokasyonu timpanik parçada kırık ile
sonuçlanabilir. Bu çalışmanın amacı, MFT ve DKY kırıklarının ilişkisinin Konik
Işınlı Bilgisayarlı Tomografi (KIBT) kullanılarak değerlendirilmesidir.
Gereç ve Yöntemler: 2016-2019
yılları arasında alınan 65 hastanın KIBT görüntüleri; olası DKY, maksilla,
mandibula ve kondil kırıklarını saptamak için bir araştırmacı tarafından
değerlendirildi. Tanımlayıcı ve ayrıntılı istatistikler SPSS 20.0 sürümü (IBM,
ABD) kullanılarak yapıldı. Gözlemci içi güvenilirlik Weighted Cohen’s Kappa
katsayısı kullanılarak hesaplandı.
Bulgular: DKY
kırıkları, hastaların % 40’ında görüldü. DKY kırıklarının % 47.4 ve % 41.7’si
sırasıyla maksiller ve mandibular kırıklarla ilişkiliydi. DKY kırıklarının %
42.3’ü bilateraldi. Sol ve sağ kondil kırıkları, sırasıyla % 41.7 ve % 45.5
oranında ilgili tarafın DKY kırığıyla birlikte görüldü. DKY ve diğer kırıklar
arasındaki istatistiksel anlamlılığı değerlendirmek için Ki-kare testi
kullanıldı.
Sonuç: DKY’nin
timpanik parçası, maksillofasiyal travmalarda kendisine gelen kuvvete bağlı
olarak kırılabilir. Maksillofasiyal travma hastalarının değerlendirilmesinde,
DKY kırıklarını gözden kaçırmamak için KIBT görüntüleri dikkatle
incelenmelidir.
ANAHTAR KELİMELER
Çoklu travma, Dış kulak yolu, Mandibular
kondil
Keywords
References
- 1. Chong VFH, Fan YF.External Auditory Canal Fracture Secondary to Mandibular Trauma. Clin Radiol 2000;55:714-6. 2. Kelly KE,Mohs DC.The External Auditory canal. Otolaryngol Clin North Am 1996;29:725-39. 3. Graham MD, Larouere MJ. Miscellaneous external auditory canal problems. In: Brackmann DE, Shelton C, Arriaga MA, eds. Otologic Surgery. Philadelphia: WB Saunders; 1994:64-8. 4. Rappaport HN, Scholl DP, Harris HJ. Injury to the glenoid fossa. Plast Reconstr Surg 1986;77:304‐8. 5. Copenhaver HR, Dennis JD, Kloppedal E, Edwards BD, Cheffer BR. Fracture of the glenoid fossa and dislocation of the mandibular condyle into the middle cranial fossa. J Oral Maxillofac Surg 1985;43:974‐7. 6. Musgrove TB. Dislocation of the mandibular condyle into the middle cranial fossa. Br J Oral Maxillofac Surg 1986;24:22‐7. 7. Tornes K, Lind O. Cranial dislocation of the mandibular condyle. A case report with an unusual hearing loss. J Craniomaxillofac Surg 1995;23:302‐4. 8. Murthy P, Bandasson C, Dhillon RS. Temporomandibular joint dislocation and deafness from a cricket ball injury. J Laryngol Otol 1994;108:415‐6. 9. European Commissionz. Radiation protection 172. Evidence based guidelines on cone beam CT for dental and maxillofacial radiology. Luxembourg: Office for Official Publications of the European Communities; 2012 10. Hofmann E, Schmid M, Sedlmair M, Banckwitz R, Hirschfelder U, Lell M. Comparative study of image quality and radiation dose of cone beam and low‐dose multislice computed tomography–an in‐vitro investigation. Clin Oral Investig 2014;18:301‐11. 11. Burchhardt DM, David J, Eckert R, Robinette NL, Carron MA, Zuliani GF. Trauma patterns, symptoms, and complications associated with external auditory canal fractures. Laryngoscope 2015;125:1579‐82. 12. Gomes MB, Guimarães SM, Filho RG, Neves AC. Traumatic fractures of the tympanic plate: a literature review and case report. Cranio 2007;25:134‐7. 13. Altay C, Erdoğan N, Batkı O, Eren E, Altay S, Karasu S et al. Isolated tympanic plate fracture frequency and its relationship to mandibular trauma. Can Assoc Radiol J 2014;65:360‐5. 14. Wood CP, Hunt CH, Bergen DC, Carlson ML, Diehn FE, Schwartz KM et al. Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries. Am J Neuroradiol 2014;35:186‐90. 15. Burchhardt DM, David J, Eckert R, Robinette NL, Carron MA, Zuliani GF. Trauma patterns, symptoms, and complications associated with external auditory canal fractures. Laryngoscope 2015;125:1579‐82.
Abstract
Background: The external
auditory canal (EAC) is a frequently disregarded region in the assessment of
maxillofacial traumas (MFT). The anterior and inferior walls of EAC occur from
the tympanic portion of the temporal bone. Tympanic plate is in close proximity
with temporomandibular joint. Posterior and anteromedial dislocation of the
condyle can result with fracture in the tympanic plate when the condyle is
forced against to EAC. The aim of this study to evaluate association with MFT
and EAC fractures by using Cone Beam Computed Tomography (CBCT).
Methods: CBCT
images of 65 patients undertaken between 2016 and 2019 were assessed by one
observer to detect the probable EAC, maxilla, mandible and condyle fractures.
Descriptive and detailed statistics were performed using SPSS version 20.0
(IBM, USA). Intra-observer reliability was calculated using Weighted Cohen's
kappa coefficients.
Results: EAC
fracture was determined in 40 % of the patients. Of the EAC fractures, 47.4 %
and 41.7 % were associated with maxillary and mandibular fractures,
respectively. Of the EAC fractures, 42.3 % were bilateral. Left and right
condyle fractures were detected together with 41.7 % and 45.5 % of the related
side EAC fractures, respectively. Chi‐squared test was
used to evaluate statistical significance between EAC and other fractures.
Conclusion: Tympanic plate of EAC can fracture depending on the force against to
it in MFT. In the assessment of maxillofacial trauma patients, CBCT images
should be carefully evaluated not to overlook EAC fractures.
KEYWORDS
Ear canal,
Mandibular condyle, Multiple trauma
Keywords
References
- 1. Chong VFH, Fan YF.External Auditory Canal Fracture Secondary to Mandibular Trauma. Clin Radiol 2000;55:714-6. 2. Kelly KE,Mohs DC.The External Auditory canal. Otolaryngol Clin North Am 1996;29:725-39. 3. Graham MD, Larouere MJ. Miscellaneous external auditory canal problems. In: Brackmann DE, Shelton C, Arriaga MA, eds. Otologic Surgery. Philadelphia: WB Saunders; 1994:64-8. 4. Rappaport HN, Scholl DP, Harris HJ. Injury to the glenoid fossa. Plast Reconstr Surg 1986;77:304‐8. 5. Copenhaver HR, Dennis JD, Kloppedal E, Edwards BD, Cheffer BR. Fracture of the glenoid fossa and dislocation of the mandibular condyle into the middle cranial fossa. J Oral Maxillofac Surg 1985;43:974‐7. 6. Musgrove TB. Dislocation of the mandibular condyle into the middle cranial fossa. Br J Oral Maxillofac Surg 1986;24:22‐7. 7. Tornes K, Lind O. Cranial dislocation of the mandibular condyle. A case report with an unusual hearing loss. J Craniomaxillofac Surg 1995;23:302‐4. 8. Murthy P, Bandasson C, Dhillon RS. Temporomandibular joint dislocation and deafness from a cricket ball injury. J Laryngol Otol 1994;108:415‐6. 9. European Commissionz. Radiation protection 172. Evidence based guidelines on cone beam CT for dental and maxillofacial radiology. Luxembourg: Office for Official Publications of the European Communities; 2012 10. Hofmann E, Schmid M, Sedlmair M, Banckwitz R, Hirschfelder U, Lell M. Comparative study of image quality and radiation dose of cone beam and low‐dose multislice computed tomography–an in‐vitro investigation. Clin Oral Investig 2014;18:301‐11. 11. Burchhardt DM, David J, Eckert R, Robinette NL, Carron MA, Zuliani GF. Trauma patterns, symptoms, and complications associated with external auditory canal fractures. Laryngoscope 2015;125:1579‐82. 12. Gomes MB, Guimarães SM, Filho RG, Neves AC. Traumatic fractures of the tympanic plate: a literature review and case report. Cranio 2007;25:134‐7. 13. Altay C, Erdoğan N, Batkı O, Eren E, Altay S, Karasu S et al. Isolated tympanic plate fracture frequency and its relationship to mandibular trauma. Can Assoc Radiol J 2014;65:360‐5. 14. Wood CP, Hunt CH, Bergen DC, Carlson ML, Diehn FE, Schwartz KM et al. Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries. Am J Neuroradiol 2014;35:186‐90. 15. Burchhardt DM, David J, Eckert R, Robinette NL, Carron MA, Zuliani GF. Trauma patterns, symptoms, and complications associated with external auditory canal fractures. Laryngoscope 2015;125:1579‐82.
Details
| Primary Language | English |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | November 11, 2019 |
| Submission Date | January 19, 2019 |
| Published in Issue | Year 2019 Volume: 6 Issue: 4 |
Selcuk Dental Journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).