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General E.N.T. evaluation in head injury cases with special reference to temporal bone injury.

INTRODUCTION: CONCLUSION AND INTERPRETATION: Majority of patients fall in 21-30 years; less in young as well as older groups. So children should be discourage from driving and specially the fast driving:

1. Roadside injuries were the most common cause of head injuries. Another factor is that noncompliance of putting head gears and to tie belts during the driving lead to these deadful injuries.

2. Dizziness and headache were the major symptoms. Proper rest, restrictions of movements by these patients does help them and they should also avoid unnecessary medication which help them and they should also avoid unnecessary medication which will hinder with the central compensation of these patients. Usually the compensation occurs in 6-8 weeks-time. Head ache present in most of the patients was releaved with passage of time.

3. Bleeding from nose along with CSF rhinorrhoea was also one of the signs. It stopped after few days; these patients should not be given local medications. Antibiotics may be given to avoid infection.

4. Bleeding from nose along the CSF rhinorrhea was also one of the signs. It usually stops. The patients are given bed rest with head rest. Valsalva's manoeure is avoided. CSF Fistulae usually closes by 10 days. Surgical correction should only be undertaken if it persist after 10 days. All Mid face fractures should be corrected before three weeks as after that permanent disunion occur and it may not be possible to correct them properly.

5. Facial paralysis was also notable sign.

6. Facial paralysis in cases where the onset is early, the prognosis is usually better with or without Surgery. If transverse temporal bone fractures with complete facial paralysis and total hearing loss then facial should be decompressed by translabyrinthyne approach. If hearingis good and lesion is in pregeniculate region then transmestroid along with middle cranialfossa approach should be preferred. Facial paralysis with delayed on set has poor prognosis. Similarly the facial paralysis associated with transverse fracture has got poor prognosis. Surgical decompation should be taken in these patients within 3 to 6 days or if Electrodiagnostic tests shows 90 percent degeneration of the nerve.

7. Patients with longitudinal fractures showed mostly conductive type of hearing loss while mixed hearing loss was also reported in few cases. All transverse fracture cases showed sensory neural hearing loss. Conductive deafness due to blood in middle ear and patients gets improvement in hearing. So is true of tympanic membrane perforation which also gets healed in 10 to 15 days.

8. CSF otorrhea subsided after 10 days of medication and hospitalization. CSF otorrhea usually associated with bleeding from ears sometime it's masked by blood. These patients should be given antibiotics specially those which cross the blood brain barrier to avoid meningeal infection. Only if it persists upto two weeks then surgical intervention should be thought off. However CSF otorrhea signifies tear in dura and in turn fracture.

9. Bleeding from throat is usually due to nose bleed or blood from ears through Eustachian tube enter the nasopharynx

10. Role of CT scan is of immense value, particularly useful in CSF rhinorhea and CSF otorrhoea cases in finding out the exact site of bone injury and thus useful in their management.

DOI: 10.14260/jemds/2015/762

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Otol Neurotol. 2008; 29(3): 344-9.

Vikramjit Singh Parmar [1], S. V. Golhar [2], P. Deshmukh [3], Poonam Pathania [4]

AUTHORS:

[1.] Vikramjit Singh Parmar

[2.] S. V. Golhar

[3.] P. Deshmukh

[4.] Poonam Pathania

PARTICULARS OF CONTRIBUTORS:

[1.] Assistant Professor, Department of ENT, MAMC, Agroha, Hisar.

[2.] Professor, Department of ENT, AVBRH, Sawangi, Wardha.

[3.] Professor, Department of ENT, AVBRH, Sawangi, Wardha.

[4.] Post Graduate Student, Department of Prosthodontics, Swami Devi Pyal Dental College.

FINANCIAL OR OTHER COMPETING INTERESTS: None

NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:

Dr. Vikramjit Singh Parmar, # 1, Jagadish Ashram, Patiala, Punjab.

E-mail: nndy2@rediffmail.com

Date of Submission: 06/02/2015. Date of Peer Review: 07/02/2015. Date of Acceptance: 31/03/2015. Date of Publishing: 13/04/2015.
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Title Annotation:ORIGINAL ARTICLE; ear, nose, throat
Author:Parmar, Vikramjit Singh; Golhar, S.V.; Deshmukh, P.; Pathania, Poonam
Publication:Journal of Evolution of Medical and Dental Sciences
Article Type:Report
Date:Apr 13, 2015
Words:985
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