Ear Nose Throat Manifestations in Head Injury Cases Necessitating Hospitalization

Abstract

Introduction: Major consequences of head injury arise either from traumatic brain injury or from temporal bone fracture. Critical intracranial injuries often demand early management, thus overlooking ear nose throat manifestations. This study was undertaken to highlight the otorhinolaryngeal manifestations necessitating hospital admission in cases of head injuries.

Material and methods: A prospective study was conducted in a tertiary care hospital of Indian Armed Forces to study the otorhinolaryngeal manifestations necessitating hospital admission in 30 patients of head injuries fulfilling the requisite criteria. After a thorough clinical examination, appropriate radio-imaging studies were done for head injury, temporal bone fracture and nasal fracture. Hearing was evaluated by pure tone audiogram. Data was analyzed using validated statistical software.

Results: Majority were male in the age group of 30-40 years having sustained head injury in road traffic accidents. 90% patients showed otological manifestations including ear bleed, Battle sign, hemotympanum, perforation of tympanic membrane, hearing loss, tinnitus, vertigo, nystagmus, facial palsy, and CSF otorrhea. 50% cases of otic capsule violating fractures were complicated with facial palsy, sensorineural hearing loss, tinnitus and vertigo. Nasal findings were noted in 56.6% cases which included epistaxis, impaired olfaction, CSF rhinorrhea and maxillofacial fractures. Extradural hemorrhage, subarachnoid hemorrhage and subdural hemorrhage were seen in 23.3% cases. There were no cases with throat manifestations.

Conclusion: A large proportion of cases of head injury necessitate hospitalization for management by a multi-specialty team. Major consequences of such events arise either from brain injury or from temporal bone fracture. Though life-saving neurosurgical intervention is always a priority, timely appropriate attention to otorhinolaryngeal morbidities cannot be overemphasized.