Parapharyngeal emphysema after fracture of the tympanic portion of the temporal bone . A case report
Abstract Introduction and objective: Facial trauma is a common reason for consultation and, although the presence of associated fractures is rare, it is sometimes necessary to perform imaging tests to help rule them out. The intimate relationship between the temporomandibular joint and the tympanic portion of the temporal bone explains that certain mandibular traumas are accompanied by fracture of the tympanic portion of the temporal bone. Description: We present the case of a 79-year-old male patient who, after suffering facial trauma, underwent a computed tomography scan that showed a fracture of the tympanic portion of the left temporal bone with ipsilateral parapharyngeal emphysema. Discussion: This type of fracture usually occurs in the context of mandibular trauma, in which the mandibular condyle impacts the anterior wall of the external auditory canal. Performing a computed tomography scan is essential for its diagnosis, and air can be observed around the temporomandibular joint and very rarely parapharyngeal emphysema. In the cases described in the literature, the attitude acquired in this type of situation is expectant. Conclusions: The complication of the fracture of the tympanic portion of the temporal bone in the form of parapharyngeal emphysema is very rare. However, despite its low incidence, in mandibular trauma the possible existence of associated fractures and their complications must be taken into account.
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Jiang Y, Jiang C, Huang X. Associations between condylar fractures and external auditory canal fracture: A 7-year retrospective study. J Craniomaxillofac Surg. 2022;50(2):140-145.
Plaza G, Martínez-San Millán J, Navas C, Martínez-Vidal A. Parapharyngeal emphysema-an unusual complication of temporal bone trauma. J Laryngol Otol. 1998;112(3):301-302.
Matos J, Oliveira P, Ferreira M, Conde A. Parapharyngeal space emphysema by temporal bone fracture resulting from mandibular trauma. Braz J Otorhinolaryngol. 2013;79(4):525.
Altay C, Erdoğan N, Batkı O. Isolated tympanic plate fracture frequency and its relationship to mandibular trauma. Can Assoc Radiol J. 2014;65(4):360-365.
Betz B, Wiener M. Air in the temporomandibular joint fossa: CT sign of temporal bone fracture. Radiology. 1991;180(2):463-466.
Montaser A, Goyal M, Weiner M. Air in temporomandibular joint: an indirect, specific CT sign of temporal bone fracture in the setting of head trauma. J Trauma. 2011;70(4):73.
Wood C, Hunt C, Bergen D. Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries. Am J Neuroradiol. 2014;35(1):186-190.
Kurihara YY, Fujikawa A, Tachizawa N, Takaya M, Ikeda H, Starkey J. Temporal Bone Trauma: Typical CT and MRI Appearances and Important Points for Evaluation. Radiographics. 2020;40(4):1148-1162.
Chong VF, Fan YF. Technical report. External auditory canal fracture secondary to mandibular trauma. Clin Radiol. 2000;55(9):714-716.
Burchhardt D, David J, Eckert R, Robinette N, Carron M, Zuliani G. Trauma patterns, symptoms, and complications associated with external auditory canal fractures. Laryngoscope. 2015;125(7):1579-1582.
Jiang Y, Jiang C, Huang X. Associations between condylar fractures and external auditory canal fracture: A 7-year retrospective study. J Craniomaxillofac Surg. 2022;50(2):140-145.
Plaza G, Martínez-San Millán J, Navas C, Martínez-Vidal A. Parapharyngeal emphysema-an unusual complication of temporal bone trauma. J Laryngol Otol. 1998;112(3):301-302.
Matos J, Oliveira P, Ferreira M, Conde A. Parapharyngeal space emphysema by temporal bone fracture resulting from mandibular trauma. Braz J Otorhinolaryngol. 2013;79(4):525.
Altay C, Erdoğan N, Batkı O. Isolated tympanic plate fracture frequency and its relationship to mandibular trauma. Can Assoc Radiol J. 2014;65(4):360-365.
Betz B, Wiener M. Air in the temporomandibular joint fossa: CT sign of temporal bone fracture. Radiology. 1991;180(2):463-466.
Montaser A, Goyal M, Weiner M. Air in temporomandibular joint: an indirect, specific CT sign of temporal bone fracture in the setting of head trauma. J Trauma. 2011;70(4):73.
Wood C, Hunt C, Bergen D. Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries. Am J Neuroradiol. 2014;35(1):186-190.
García-Fernández, R., Gasós-Lafuente, A. M., María, & Lavilla-Martín de Valmaseda, M. J. (2023). Parapharyngeal emphysema after fracture of the tympanic portion of the temporal bone . A case report. Revista ORL, 15(2), e31791. https://doi.org/10.14201/orl.31791
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