Rationale and Objectives
The aim of this study was to preliminarily investigate whether an enlarged geniculate ganglion fossa (GGF) on temporal bone computed tomography can diagnose GGF fracture in patients with traumatic facial paralysis by evaluating the diameter of the GGF.
Materials and Methods
Thirty-six patients who underwent computed tomography before confirmation of GGF fracture on otologic surgery were recruited into a study group. Additionally, a cohort of 107 patients with no histories of head trauma, no structural abnormalities of inner ear, and no clinical symptoms of facial nerve disability who underwent computed tomography for other reasons were selected as a control group. The diameters of the GGFs of the study group were evaluated by two observers and compared retrospectively with those of the control group. Wilcoxon’s test was used to compare discrepancies of both sides, and intraclass correlation coefficients were used to evaluate intraobserver and interobserver reliability.
Results
The measurement of diameters showed good interobserver and intraobserver consistency. The discrepancy in the measurement of transdiameter between both sides of the GGF on reformatted transverse images of the study group was significantly different from that of the control group (Wilcoxon’s test, P < .001). Discrepancy in the GGF on transverse images of the study group was larger than that of the control group. A significant difference existed in the discrepancy in vertical diameter between the study and control groups (Wilcoxon’s test, P < .001) as well.
Conclusions
An enlarged GGF on temporal bone computed tomography offers an additional sign for the diagnosis of GGF fracture in patients with traumatic facial paralysis.
The incidence of temporal bone trauma and associated facial nerve injury has increased with increasing accidents. It has been reported that 14% to 22% of patients with skull fractures have temporal bone fractures , which are frequently attributable to falls, traffic accidents, and assaults . Facial paralysis, one of the most severe complications caused by temporal bone fracture, is usually obvious, affecting facial expression, oral competence, and taste.
Clinically, patients with facial nerve dysfunction are treated either conservatively or surgically. Surgical treatment such as facial nerve decompression is carried out depending on diagnostic and topognostic examination, and the choice of surgical approach is guided by the fracture location. A fracture line of the temporal bone demonstrated on computed tomographic (CT) images is one of the prominent indications for decompression of the facial nerve . Temporal bone CT imaging can depict the facial canal and the direction of temporal bone fractures. Most fracture lines can be depicted, with sensitivity as high as 90% .
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Materials and methods
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Results
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Analysis of the Transdiameter of the GGF
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Analysis within the control group
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Analysis within the study group
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Analysis between the study and control groups
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Analysis of the Vertical Diameter of the GGF
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Analysis within the control group
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Analysis within the study group
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Analysis between the study and control groups
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Count of Temporal Bone Fractures
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Discussion
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Conclusions
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