Between 0 and 55% of patients seen in casualty each year with a head injury are reported to suffer from a sensorineural hearing loss. There are 2 broad groups; those with and those without a temporal bone fracture, the former generally having a better outcome. Temporal bone fractures are classified as longitudinal, transverse or mixed types. The location of fractures responsible for causing a sensorineural loss are most commonly through the cochlear. Associated complications include facial nerve palsy, cerebrospinal fluid leak, a perilymph fistula, dizziness and tinnitis.
Investigation and management of these cases involves MRI scanning and audiometric studies, including stapedial reflex decay, evoked brainstem auditory response and otoacoustic emission cochleography. Treatment options are hearing aids and cochlear implants for selected patients.