Chapter 145 Management of Temporal Bone Trauma - PowerPoint Presentation

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Chapter 145Management of Temporal Bone Trauma

Quinton Gopen, M.D.UCLA Medical Center

Question 1: Temporal Bone fractures are classified as longitudinal or transverse based on the fracture line relationship to:

Coronal Plane

Axial Plane

Sagital

Plane

Petrous RidgeTemporal Line

Question 2Temporal bone fractures entering into the otic

capsule generally result from blows to the

Temporal Region

Occipital Region

Parietal Region

Frontal RegionParasaggital

Region

Question 3The incidence of otic

capsule involvement is generally considered to occur in what percentage of temporal bone fractures?

5%

10%

20%

40% 80%

Enter Question TextFacial nerve involvement

Intracranial complicationsComminuted fractures

Concurrent C-spine injuriesNone of the above

Question 4

Pediatric temporal bone fractures differ from adult temporal bone fractures in that pediatric fractures have a lower incidence of

Enter Question Text

MRI scan brainCT angiographyCaloric testing

VEMP testing

CT temporal bones

Question 5

An 18y.o. man sustains a temporal bone fracture based on initial head CT on presentation to the ER. The patient complains of pain over the fracture site and hearing loss. The patient has no vertigo,

nystagmus

or other neurologic symptoms. What is the next best test to obtain?

Enter Question Text

Oral corticosteroid therapyFacial nerve decompression via a transmastoid approach

Facial nerve decompression via a middle fossa

approach

Facial nerve decompression via a combined

transmasoid-middle fossa

approach

Facial nerve decompression via a

translabyrinthine

approach

Question 6

A 74

y.o

. man sustains a temporal bone fracture. The fracture extends through the

geniculate

ganglion and is comminuted. The man has near complete facial paralysis but does have some minimal movement of the face on maximal effort. His hearing is grossly intact. The best treatment plan is:

Enter Question Text

Vertical segment Horizontal segmentPerigeniculate

regionMeatal

segment

Second

genu of the facial nerve

Question 7

The site of facial nerve injury in the majority of temporal bone fractures is the:

Enter Question Text

Immediately following the injury1 day3 days

10 days

21 days

Question 8

The theoretical time for the maximal regeneration of axoplasmic flow is considered to be how long after the injury

Enter Question Text

50%75%90%

95%100%

Question 9

An

ENoG

results showing this percentage of degeneration or greater of the facial nerve is generally considered to be an indication for surgical exploration and decompression (

Fisch

criteria)

Enter Question Text

Bed rest Serial lumbar puncturesLumbar drain

Surgical exploration with closure of the ear canal

Surgical exploration with mastoid obliteration

Question 10

The best initial treatment for acute posttraumatic CSF otorrhea is:

Chapter 129Physiology of the Auditory System

Quinton Gopen, M.D.UCLA Medical Center

Enter Question Text

5300 Hz3000 HZ1200 Hz

800 Hz100 Hz

Question 1

What is the resonant frequency of the external auditory canal?

Question 2What is labeled as “?” in the adjacent histopathologic

slide?Helicotrema

Scala

Tympani

Scala

MediaScala

Vestibuli

Organ of

Corti

?

Question 3A patient presents with a mixed hearing loss. The vestibular evoked myogenic

potential response is recorded at a sound threshold of 120dB? What is the most likely diagnosis

Otosclerosis

Superior semicircular canal

dehisence

Meniere’s

Disease

Connexin

26 gene mutation

Usher’s syndrome

Question 4Type I spiral ganglion cells:

Less common than type II spiral ganglion cellsAre

myelinated

Project to between 3 and 5 inner hair cells

Project to between 3 and 5 outer hair cells

None of the above

Question 5The auditory cortex is located within the

Temporal lobeOccipital lobe

Parietal lobe

Brainstem

Midbrain

Question 6The speed of sound waves in air is roughly

120 meters per second340 meters per second

630 meters per second

1220 meters per second

1500 meters per second

Question 7The cochlear duct is filled with

Endolymphatic fluid

Perilymphatic fluid

Dense collagen like material

Cerebrospinal fluid

Loose fibrous tissue

Question 8What is considered the first relay station for all ascending auditory information

Lateral lemniscus

Auditory nerve

Medial

geniculate

bodyCochlear nucleus

Heschyl

gyrus

Question 9Binaural squelch refers to

The ability of the brainstem auditory nuclei to increase the signal to noise ratio Signal received by both ears is greater in amplitude than the signal received by a single ear

Outer hair cell control over the inner hair cells

Uncomfortable feedback created by hearing aids

The sound in your mind created by reading this question

Question 10The primary auditory cortex is

tonotopically tuned such that the highest frequencies are at the

medial aspect

lateral aspect

superior aspect

inferior aspectCentral aspect