Temporal bone trauma and facial paralysis.

Temporal bone trauma includes a wide range of injuries of greater and lesser severity, most of which require the immediate attention of an otolaryngologist. The most common temporal bone injuries encountered in an emergency room setting include longitudinal and transverse fractures of the temporal bone with and without facial paralysis, labyrinthine concussion, foreign bodies in the external canal, penetrating injuries via the external auditory canal, and pressure injuries, including otitic barotrauma, water skiing accidents, blows or slaps to the ear or side of the head, and severe impact noise. A brief but inclusive examination can be performed within the limitations necessarily imposed by an emergency room setting. Cranial nerve screening, balance testing, hearing, and vestibular evaluation can be accomplished with a considerable degree of accuracy. To a large extent, the long term result reflects the quality of the initial examination.