1.
Longitudinal vs. transverse fractures: Draw the “prototypical” fracture lines and their relationship to important temporal bone structures.
2.
Longitudinal vs. transverse fractures: Which is more common? What do you expect to see on otoscopic exam? What kind of hearing loss is associated with each? What is their association with CN VII injury?
3.
You are called to the Trauma Unit for a patient who suffered blunt trauma to the head who now has blood from the ear. CT scan shows a longitudinal temporal bone fracture. On exam, you see and EAC laceration and tympanic membrane perforation. What is your initial management? What do you tell the patient about prognosis regarding spontaneous closure of the perforation?
4.
External auditory canal fractures: Discuss patterns, management and complications.
Reference(s):
Menheniott, T. R., Judd, L. M., & Giraud, A. S. (2015). STAT3: a critical component in the response to Helicobacter pylori infection. Cellular Microbiology, 17(11), 1570–1582.
5.
How do you diagnose perilymphatic fistula? What is your initial management? What are indications for surgery?
6.
A patient presents to the ER at 1 AM after being “pistol whipped” on the side of his head. He complains of severe hearing loss and vertigo with nystagmus and a tympanic membrane perforation on exam. Do you call in Dr. (your otologist) from his warm and cozy bed for an immediate exploration? What are you likely to find?
7.
Your junior resident calls you from the Trauma Unit. He is evaluating an otherwise stable patient with a temporal bone fracture and complete ipsilateral facial nerve paralysis. He wants to know what to do?
8.
How do you diagnose CSF otorrhea? Do you start antibiotics? What is your initial management? What if it persists?
9.
Etiologies and management of traumatic tympanic membrane perforation.
10.
Indications for surgical exploration of complete and incomplete facial nerve paralysis after blunt trauma with a temporal bone fracture.
11.
Does surgical timing have an impact on outcomes?
Reference(s):
Xu, P., Jin, A., Dai, B., Li, R., & Li, Y. (2017). Surgical timing for facial paralysis after temporal bone trauma. American Journal of Otolaryngology, 38(3), 269–271.
12.
On your oral board exam, you are presented with this scenario: A 20 year-old male is admitted to the Trauma Unit after a GSW to the head. He was found obtunded in an alley, but with stable vital signs. There is no other information. You are called because he is bleeding profusely from the ear. What do you want to do (hint…do not forget ABC’s!)?
13.
Provide an update on pediatric temporal bone fractures.
Reference(s):
Dunklebarger, J., Branstetter, B. 4th, Lincoln, A., Sippey, M., Cohen, M., Gaines, B., & Chi, D. (2014). Pediatric temporal bone fractures: current trends and comparison of classification schemes. The Laryngoscope, 124(3), 781–784.