Long-Term Outcomes of Adult Temporal Bone Fractures With Hearing Loss: Results of a Multinational Database Analysis.

OBJECTIVE

Temporal bone fractures (TBFs) can result in long-term adverse outcomes including meningitis, facial nerve disorders (FNDs), and hearing loss (HL) that may require surgical intervention. This epidemiologic study aims to examine the sequelae of adult TBF with HL, including the utilization of cochlear implantation (CI), using data from a large, multinational database.

METHODS

Using the TriNetX database, a retrospective cohort study was performed of adults (≥ 18 years) using ICD10 codes for other fractures of the base of the skull and hearing loss, an approximation of TBF with hearing loss. A control group of adults without TBF was used. Measured outcomes included meningitis, CI, FND, cerebrospinal fluid (CSF) leak, and labyrinthitis. Propensity score matching (1:1) was used for cohorts smaller than 33,333,333. Ninety-five percent of patient data used was from 2006 to 2023.

RESULTS

Adults with TBF and HL (n = 34,878) had a greater risk of meningitis any time after TBF than those without TBF (n = 105,035,185) (RR: 6.65, 95% CI: 5.74-7.70). Labyrinthitis (RR: 3.56, 95% CI: 2.86-4.41), CSF leak (RR: 40.71, 95% CI: 37.91-43.71), and FND (RR: 12.08, 95% CI: 11.62-12.55) were more common after TBF. CI was more common after TBF (RR: 26.22, 95% CI: 22.12-31.07). Meningitis after TBF was associated with an increased risk of CSF leak (RR: 3.0, 95% CI: 1.52-5.93) compared to those without meningitis.

CONCLUSION

Adults who sustain TBFs resulting in HL have an increased risk of developing meningitis, labyrinthitis, CSF leak, and FND and are more likely to undergo CI for aural rehabilitation compared to a control cohort.

LEVEL OF EVIDENCE: Level IV.