Vertigo, dizziness, and tinnitus after otobasal fractures.

Abstract

Some 15% of temporal bone fractures are produced by blows to the occiput. The fracture line begins in the posterior fossa, at or near the foramen magnum, and crosses the petrous ridge through the internal auditory canal or the otic capsule. Thus, it is called a transverse fracture. In cases of transverse fractures of the temporal bone, due to automobile accidents or other causes of head injury, the labyrinth is involved more frequently than in longitudinal fractures. Severe vertigo with severe or total hearing loss is not uncommon in such injuries. In milder injuries, labyrinthine "concussion" may occur, with transitory auditory-vestibular symptoms. The force that causes the fracture is so great that it not only fractures the base of the skull but may cause a lesion of the brainstem, resulting in a combined peripheral and central lesion. We evaluated 61 patients (50 [81.97%] male, 11 [18.03%] female) with neurootological complaints of sequelae of otobasal fractures. Of these, 40.98% complained of tinnitus and 52.82% of hearing loss. Reviewing our experimental neurootometric investigations, we identified pathological processes on 75.41% of the butterfly calorigrams and 72.13% of the stepping craniocorpograms, as well as in 32.79% and 39.34% of subjects on right- and left-ear bone-conduction audiometry, respectively.