{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:44:22Z","timestamp":1790837062913,"version":"4.1.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Temporal bone fractures form a major skull-base injury subset, yet prognostic data\u2014drawn chiefly from short-term Western cohorts\u2014remain sparse. This study therefore investigated long-term audiometric and vestibular outcomes by otic-capsule integrity to refine recovery estimates and treatment efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of 1,871 adults with traumatic temporal bone fractures treated at a Level I trauma center in China (2014\u20132023). Patients were stratified by otic capsule status: sparing (OCS, <jats:italic>n<\/jats:italic> = 1,617) vs. violating (OCV, <jats:italic>n<\/jats:italic> = 254). Primary outcomes included pure tone audiometry and Dizziness Handicap Inventory scores assessed over 24 months. Statistical analysis employed mixed-effects models, Kaplan-Meier survival analysis, and propensity score matching. Two <jats:italic>a priori<\/jats:italic> hearing endpoints were used: \u201cnormal hearing\u201d (PTA \u226425 dB HL) and \u201cfunctional hearing recovery\u201d (\u226530 dB improvement from baseline).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline hearing impairment was significantly worse in OCV patients (84.6 \u00b1 8.7 vs. 45.1 \u00b1 8.5 dB HL, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). At 24-month follow-up, functional hearing recovery (\u226530 dB improvement) occurred in 90.4% of OCS patients, whereas 0% of OCV patients reached this threshold; return to normal hearing (PTA \u226425 dB HL) was observed in 38.5% of OCS patients and 0% of OCV patients. Multivariable analysis identified OCV fracture as the strongest predictor of severe hearing loss (OR 4.89, 95% CI: 3.42\u20136.99, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Complication rates were five-fold higher in OCV patients (31.5 vs. 6.1%, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), including cerebrospinal fluid leak (13.8 vs. 2.0%) and meningitis (4.3 vs. 0.7%). Propensity-matched analysis demonstrated surgical benefit, with 7.6 dB hearing improvement compared to conservative management (<jats:italic>p<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Otic capsule integrity represents the primary determinant of recovery following temporal bone fractures. OCV fractures demonstrate profound, persistent deficits with minimal recovery potential, while OCS fractures show excellent recovery prospects. These findings provide crucial prognostic information for patient counseling and treatment planning in temporal bone trauma management.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1663771","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T05:50:40Z","timestamp":1759297840000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Audiometric and vestibular outcomes following temporal bone fractures: a retrospective analysis of a major trauma center cohort in China"],"prefix":"10.3389","volume":"12","author":[{"given":"Caijuan","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1007\/s12070-024-04519-9","article-title":"Temporal bone fractures after trauma: a prospective analysis of presentation, management, and outcomes","volume":"76","author":"Kumar","year":"2024","journal-title":"Indian J Otolaryngol Head Neck Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"52","DOI":"10.3390\/therapeutics1020007","article-title":"Dilemmas in diagnosis and management of temporal bone fractures and their sequelae","volume":"1","author":"Powell","year":"2024","journal-title":"Therapeutics."},{"key":"B3","doi-asserted-by":"publisher","first-page":"93","DOI":"10.4103\/am.am_12_19","article-title":"Skull-base fractures: pearls of etiopathology, approaches, management, and outcome","volume":"16","author":"Rao","year":"2019","journal-title":"Apollo Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/00034894001090S502","article-title":"Temporal bone studies of the human peripheral vestibular system. 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