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Original article
Clinical-radiological Correlation in Temporal Bone Fractures
Correlación clínico-radiológica de las fracturas dehueso temporal
José Manuel Morales Pueblaa,
Corresponding author
josemanuelmoralespuebla@gmail.com

Corresponding author.
, Natalia López Juanesd, Manuel Varo Alonsoe, Isabel Sánchez Cuadradoa,b, Javier Gavilán Bouzasa,b, Luis Lassaletta Atienzaa,b,c
a Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain
b Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain
c Centro de Investigación Biomédica en Red para Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
d Facultad de Medicina Autónoma de Madrid, Madrid, Spain
e Servicio de Radiología, Hospital Universitario La Paz, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Temporal bone fractures &#40;TBF&#41; are a serious and common type of skull base fracture&#46; They usually occur within the context of head trauma &#40;HT&#41; and constitute a serious problem for public health due to their high frequency and morbimortality&#46; The relevance of this type of fracture does not only lie within their frequency&#44; but also in the associated intracranial lesions &#40;intracranial haemorrhaging or brain oedema&#41; and the secondary involvement of the structures within the temporal bone&#44; which manifest as symptoms such as hearing loss&#44; vertigo&#44; facial paralysis or cerebrospinal fluid &#40;CSF&#41; fistula with its corresponding risk of meningitis&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The presence of immediate and complete peripheral facial paralysis&#44; labyrinthine involvement or a CSF fistula are considered medical and surgical emergencies&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> these sequelae may be permanent and severely affect the patient&#8217;s quality of life&#44; with major physical and psychological impact both for the patient and their environment&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the context of HT&#44; TBF may not be the lesion which endangers the patient&#8217;s health most immediately&#44; but early otorhinolaryngological participation within a multidisciplinary team collaboration assessment and therapeutic management&#44; may improve long-term functional outcome&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The temporal bone is a paired and symmetrical bone which is pneumatisised and which forms part of the lateral wall and the skull base&#46; It comprises five sections&#58; squamous&#44; which constitutes the middle cranial foci wall&#59; mastoid&#44; formed by the pneumatisized bone with air-filled cells&#59; the petrous or petrosal bone which is wedge-shaped with an anteromedial vertex&#59; the tympanic section&#44; corresponding to the tympanic bone and the temporal styloid process&#46; The portions mostly commonly affected in trauma are the petrous bone and the mastoids&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The petrous bone is a complex structural region with multiple cavities and cuts for containing the additive and vestibular sensory organs and for the passing of vascular and nerve structures&#46; These orifices&#44; together with the aerial axis they cross over&#44; comprise points of bony fragility which may lead to fractures&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The main diagnostic tool for TBF is computed tomography &#40;CT&#41; of the skull with fine cutaway slices &#40;&#60;1 mm&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Radiological imaging may establish classification&#44; depending on the fracture pattern&#46; The usefulness of these classifications is defined by their ability to predict clinical consequences and thus guide therapeutic management of these patients&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The traditionally used classification divides fractures into longitudinal&#44; transversal and mixed&#46; In longitudinal fractures&#44; the mechanism is a side impact and the fracture line parallels the longest axis of the petrous pyramid&#46; Transversal fractures are perpendicular to this axis and are produced by occipital or frontal impacts&#46; They are less common than longitudinal fractures&#44; but have been associated with a higher risk of severe sequelae<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Each type of fracture is classically related to a series of clinical manifestations in a characteristic manner based on their aetiopathogenesis &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Oblique fractures which do not follow a pure pathway and comminuted ones which involve more than one fracture line&#44; cannot be classified within either of the previous terms&#46; They are included into the category of mixed fractures<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and may present with any type of associated medical symptom&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In recent years other classificactions have been suggested with a more anatomical bent&#58; petrous bone fractures with involvement or preservation of the otic capsule&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> TBF with involvement or preservation of the petrous bone<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> or based on the number of temporal bone sections involved in the fracture&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The aim of this study was to undertake a systematic review of the CT images of patients who had been diagnosed with TBF and to define their radiological pattern in accordance with the traditional classification into longitudinal&#44; transversal and mixed fractures&#46; The aim was to study the interobserver concordance between events found on reviewing the imaging tests and those described in the radiological report&#44; as well as analysing the clinical variables depending on the fracture line and involvement of the otic capsule&#46; The impact of the mastoid pneumatisation will be assessed in the fracture line and the involvement of the otic capsule&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material and Methods</span><p id="par0045" class="elsevierStylePara elsevierViewall">A retrospective observational study was carried out with data obtained from the medical records of patients coded as TBF in the database of the Radiology Service of the Hospital Universitario La Paz &#40;HULP&#41; between January 2016 and May 2019&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">TBF diagnosis was established using observation of the fracture or of indirect signs &#40;occupation of the mastoid cells&#59; pneumcephalus adjacent to the temporal bone&#59; air in the glenoid fossa or in the sigmoid sinus&#59; extra-axial haematoma&#59; brain damage or pneumolabyrinth&#41;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> in CT images taken when the patient arrived at the emergency hospital services&#46; Cases with non observable radiological assessment were excluded&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> lists the variables studied&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Those cases in which the structure to be studied could not be identified in the available slices were considered as non-assessable and in the medical variables those cases where data could not be collected due to a lack of information in the medical files or due to death of the patient prior to the otorhinolaryngologic assessment&#46; The number of non assessable cases was different for each variable and was taken into account in the statistical analysis&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Pneumatisation of the temporal bone was studied according to two different classifications&#58; mastoid pneumatisation<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and apex pneumatisation&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Statistical analysis centred on the relationship with the involvement of the otic capsule&#44; since this anatomical structure was included in the pneumatisation of the temporary bone and its lesion was related to the most severe sequelae&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Change to hearing was defined using the mid tone threshold in pure tone audiometry carried out during initial examination or follow-up of the patient to frequencies of &#46;5&#44; 1&#44; 2 and 4 kHz&#44; taking as reference the ear with the best hearing&#46; To determine severity the World Health Organisation criteria were used<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#58; normal &#40;&#8804;25 dB&#41;&#44; mild &#40;26&#8722;40 dB&#41;&#44; moderate &#40;41&#8722;60 dB&#41;&#44; severe &#40;61&#8722;80 dB&#41; and profound &#40;&#8805;80 dB&#41;&#46; Cophosis was defined as the total absence of verbal audiometry discrimination&#46; For the study of the variables relating to the loss of hearing&#44; the cases were grouped into mixed hearing loss and cophosis within sensorineural hearing loss as this was the determining component of this type of auditory deterioration&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Mixed fractures were excluded from statistical analysis since the medical symptoms of these fractures is a combination of clinical findings from longitudinal and transversal medical symptoms&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Collected data were analysed using BM SPSS Statistics &#40;versi&#243;n 25&#41; software&#46; Contrast of hypotheses was performed using the &#967;<span class="elsevierStyleSup">2</span> test with Yates correction &#40;if n &#60; 200&#41; and the exact Fisher test for qualitative variables&#46; A <span class="elsevierStyleItalic">P</span> value of &#60;&#46;05 was considered to be statistically significant&#46; To study the interobserver concordance between diagnosis of the type of fracture according to the radiological report and according to imaging review the Kappa index was used for qualitative variables&#46; Concordance was considered poor if &#8804;&#46;2&#44; weak if &#46;21&#8211;&#46;4&#44; moderate if &#46;41&#8211;&#46;6&#44; good if &#46;6&#8211;&#46;8 and very good if &#46;81&#8211;1&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ethical Aspects</span><p id="par0080" class="elsevierStylePara elsevierViewall">The study was approved by the Ethics and medical Research Committee of the HULP and was conducted in keeping with the ethical principles established by the Declaration of Helsinki and Organic Act 3&#47;2018 of 5th December on the Protection of Personal Data and Seguring of Digital Rights&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">Between January 2016 and May 2019&#44; 97 patients were diagnosed with TBF through CT of the skull in the HULP&#46; Of these&#44; 94 were included in the study&#44; with a total of 110 fractures individually analysed&#46; Most fractures occurred in men &#40;n &#61; 83&#59; 91&#46;3&#37;&#41;&#46; The age range extended from two to 91 years&#44; with a mean age of 44&#46;3 years&#46; Fractures in paediatric age &#40;n &#61; 9&#41; represented 9&#46;6&#37;&#59; 16 patients presented with a bilateral fracture &#40;17&#37;&#41;&#46; The most common aetiology were falls&#44; at 60&#46;9&#37; &#40;n &#61; 67&#41;&#46; Traffic accidents were responsable for 33&#46;6&#37; &#40;n &#61; 37&#41; of fractures and aggressions for 5&#46;5&#37; &#40;n &#61; 6&#41;&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Interobservador Concordance</span><p id="par0090" class="elsevierStylePara elsevierViewall">According to radiological reports&#44; 30&#46;9&#37; of fractures were diagnosed as longitudinal &#40;n &#61; 34&#41;&#44; 31&#46;8&#37; as transversal &#40;n &#61; 35&#41; and 12&#46;7&#37; as mixed &#40;n &#61; 14&#41;&#46; In 19&#46;1&#37; the type of fracture was unspecified &#40;n &#61; 21&#41; although it was described and in 5&#46;5&#37; &#40;n &#61; 6&#41; its presence was accepted using the observation of indirect signs&#46; After reviewing the images&#44; distribution was 47&#46;3&#37; of transversal fractures &#40;n &#61; 52&#41;&#44; 30&#46;9&#37; longitudinal &#40;n &#61; 34&#41; and 17&#46;3&#37; mixed &#40;n &#61; 19&#41;&#46; 4&#46;5&#37; of the fractures &#40;n &#61; 5&#41; were considered non observable &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Interobserver concordance was studied using the kappa index as a whole and in each type of fracture separately&#46; Interobserver concordance was &#8220;good&#8221; overall &#40;&#46;637 95&#37; CI &#61; &#46;512&#8211;&#46;762&#41;&#44; in longitudinal fractures &#40;&#46;617 95&#37; CI &#61; 0&#46;456&#8211;&#46;777&#41;&#44; and in mixed fractures &#40;&#46;751 95&#37; CI &#61; &#46;577&#8211;&#46;925&#41;&#46; In transversal fractures &#40;&#46;462 95&#37; CI &#61; &#46;303&#8211;&#46;621&#41; and in cases where the fracture was not observable &#40;&#46;441 95&#37; CI &#61; &#46;352&#8211;&#46;529&#41; was &#8220;moderate&#8221; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Clinical-radiological Correlation</span><p id="par0100" class="elsevierStylePara elsevierViewall">A total of 18 patients died&#44; two of them with bilateral fractures&#44; and the mortality percentage was therefore 19&#46;1&#37;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">No relevant differences were found between paediatric patients and adults&#44; and results therefore refer to the total gobal sample&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The most common clinical manifestations after a TBF are otorrhagia &#40;41&#46;8&#37;&#41;&#44; sensorineural hearing loss &#40;13&#46;6&#37;&#41;&#44; conductive hearing loss &#40;10&#46;9&#37;&#41; and haemotympanum &#40;10&#46;9&#37;&#41;&#46; Overall outcomes of each type of fracture are summarised in <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Eardrum perforation&#44; conductive hearing loss and facial paralysis were the associated clincial variables in the highest percentage of longitudinal fracture cases&#46; Otorrhagia&#44; haemotympanum&#44; sensorineural hearing loss&#44; cophosis&#44; vertigo and cerebrospinal fluid otorrhea were the associated clinical variables in the highest percentage of transversal fractures cases&#46; Results are listed in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Twenty four point five per cent of fractures &#40;n &#61; 27&#41; presented with associated hearing loss&#44; of which 44&#37; were longitudinal &#40;n &#61; 11&#41;&#44; 55&#46;6&#37; transversal &#40;n &#61; 19&#41; and the rest mixed&#46; In hearing loss associated longitudinal fractures 83&#46;3&#37; &#40;n &#61; 10&#41; presented with conductive hearing loss and 16&#46;7&#37; with sensorineural hearing loss &#40;n &#61; 2&#41;&#46; In hearing loss associated transversal fractures&#44; 90&#46;7&#37; &#40;n &#61; 10&#41; were sensorineural hearing loss&#44; and 9&#46;1&#37; conductive &#40;n &#61; 1&#41;&#46; Conductive hearing loss associated with longitudinal fractures was significant &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41; and between sensorineural hearing loss and cophosis with transversal fractures &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;005 and <span class="elsevierStyleItalic">P</span> &#61; &#46;003&#44; respectively&#41;&#46; Only bearing in mind patients diagnosed with hearing loss&#44; the significance of the association of the type of fracture and the characteristics of the hearing loss was significant &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;001&#41;&#46; 80&#37; of fractures with ossicular chain involvement had conductive hearing loss &#40;n &#61; 4&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Forty four point five per cent of fractures &#40;n &#61; 49&#41; presented with involvement of the EAC with equal distribution &#40;36&#46;7&#37;&#41; of longitudinal and transversal fractures&#46; In 8&#46;2&#37; &#40;n &#61; 9&#41; involvement of the ossicular chain was observed&#44; with a higher frequency in longitudinal fractures &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Otic capsule involvement was present in 8&#46;2&#37; &#40;n &#61; 9&#41;&#44; of which 77&#46;8&#37; were transversal fractures &#40;n &#61; 7&#41;&#44; and 22&#46;2&#37; mixed &#40;n &#61; 2&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In 41&#46;8&#37; of fractures &#40;n &#61; 46&#41; otorrhagia was present&#44; directly more frequent in the transversal fractures &#40;37&#37;&#41; than in the longitudinal ones &#40;34&#46;8&#37;&#41; with no statistical significance&#46; A statistically significant relationship was found between otorrhagia and EAC involvement &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41; regardless of the type of fracture&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Facial paralysis was a more common symptom in longitudinal fractures than in transversal ones&#44; with the difference being that in the longitudinal &#40;n &#61; 4&#41; fractures all of them were spontaneously resolved and in the transversal fractures &#40;n &#61; 2&#41;&#44; one required surgery and the other was resolved spontaneously&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Regarding the clinical manifestations relating to the involvement of the otic capsule&#44; statistical association was demonstrated with sensorineural hearing loss &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;003&#41;&#44; cophosis &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41;&#44; facial paralysis &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;019&#41; and vertigo &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;03&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Mastoid Pneumatisation</span><p id="par0145" class="elsevierStylePara elsevierViewall">With regard to mastoid pneumatisation&#44; fractures were more common in the cases of greater pneumatisation&#44; with 30&#46;9&#37; of very good pneumatisation &#40;n &#61; 34&#41;&#44; 42&#46;7&#37; good &#40;n &#61; 47&#41;&#44; 11&#46;8&#37; moderate &#40;n &#61; 13&#41; and 14&#46;6&#37; poor &#40;n &#61; 16&#41;&#46; Regarding otic capsule involvement 11&#46;1&#37; &#40;n &#61; 1&#41; occurred in poorly pneumatisized mastoids&#44; 22&#46;2&#37; &#40;n &#61; 2&#41; in well pneumatisized mastoids and 66&#46;7&#37; &#40;n &#61; 6&#41; in very well pneumatised mastoids&#46; The association of otic capsule involvement and very good pneumatisation was statistically significant &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;024&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">The distribution of the groups regarding apex pneumatisation was of 21&#46;8&#37; with complete pneumatisation &#40;n &#61; 24&#41;&#44; 49&#46;1&#37; with partial &#40;n &#61; 54&#41; and 29&#46;1&#37; with none &#40;n &#61; 32&#41;&#46; Involvement of the otic capsule was identified in 3&#46;1&#37; of case of non-pneumatisation &#40;n &#61; 1&#41;&#44; 3&#46;7&#37; of partial pneumatisation &#40;n &#61; 2&#41; and in 25&#37; of the complete pneumatisation &#40;n &#61; 6&#41;&#46; There was a significant association with complete pneumatisation &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;003&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">It has been estimated that approximately 4&#37; of HT are combined with skull fracture&#46; 14&#37;&#8211;22&#37; of them present with a TBF&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> The majority are unilateral&#44; with a frequency of 9&#37;&#8211;20&#37; of bilateral fractures&#46; The most commonly affected population group are young adults&#44; with male predominance&#46; 8&#37;&#8211;22&#37; of these fractures may be identified within the paediatric population&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Associated mortality is estimated to be 9&#37;&#8211;12&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Demographic data found in the sample coincide with those described&#44; with the exception of mortality&#44; which presented with a higher frequency than expected &#40;19&#46;1&#37;&#41;&#44; although these events could be substantiated by the HULP being a tertiary level hospital where they receive patients with greater complexity than in other centres&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">TBF occur from high energy trauma&#44; with the main causes being traffic accidents &#40;45&#37;&#8211;47&#37;&#41;&#44; falls &#40;31&#37;&#8211;33&#37;&#41; and aggressions &#40;11&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> our results highlighted a greater frequency of falls &#40;60&#46;9&#37;&#41; than traffic accidents &#40;33&#46;6&#37;&#41;&#46; This was in keeping with the trend observed in the most recent literature&#44; which shows a reduction of fractures from traffic accidents owing to several causes such as improvement in road safety and in diagnostic technqiues&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Interobservador Concordance</span><p id="par0165" class="elsevierStylePara elsevierViewall">Traditionally&#44; TBF have been divided in longitudinal &#40;70&#37;&#8211;90&#37;&#41; and transversal &#40;10&#37;&#8211;30&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> reserving the term mixed fracture for those which are unable to be included in either of the previous groups&#46; The reproducibility of this classification has been questioned by several authors&#46; Regarding strtict definitions for each type of fracture&#44; in the Aguilar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> study up to 68&#37; of fractures wre unable to be classified as longitudinal or transversal&#46; Ghorayeb et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> only identified as longitudinal 2&#46;7&#37; of fractures in their study and showed that most of them had a creeping pathway throughout the temporal bone&#46; Dahiya et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> conducted a study with a similar pattern to ours in which only 21 fractures out of the 55 previosly diagnosed as longitudinal were identified as such in the review and no transversal fractures were found despite seven fractures being given this diagnosis&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">In our series&#44; transversal fractures were the most common&#44; both in the results obtained from the data from radiological reports and from the data collected following review of the images&#46; Depending on the different locations of the temporal bone&#44; on occasions&#44; it is difficult to label a fracture line as transversal&#46; Despite this&#44; our results in keeping with transversal fractures were moderate&#46; In contrast&#44; it is simpler to identify the higher axis of the temporal bone and label the longitudinal as mixed fractures&#44; and all the more so if in the latter case there are several fracture lines&#46; The good concordance results in these cases and in the overall assessment between radiological reports and review of images speak in favour of reproducibility of the traditional TBF classification&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Clinical-radiological Correlation</span><p id="par0175" class="elsevierStylePara elsevierViewall">After analysing the frequencies observed in the clinical findings both with the classification based on radiological reports and those based on imaging reviews&#44; it was observed that the data from the latter were better matched to those described in the literature&#46; Bearing this in mind&#44; together with the good interobserver concordance&#44; analysis of clinical-radiological correlation was made based on fracture classification from the imaging review&#46; In this way it was possible to include fractures reported in the radiological reports which had not been assigned to any group&#44; and this increased the sample size in certain variables&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The relationship of longitudinal fractures with otorrhagia and EAC&#44; tympanum and middle ear involvement due to the direction of the fracture line has been described in the literature&#46; In contrast&#44; transversal fractures usually affect the apex of the petrous bone&#44; the facial nerve and the inner ear &#40;otic capsule&#44; cochlea and vestibular system&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and tend to present with more severe sequelae&#46; In our series&#44; otorrhagia we associated with EAC involvement &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41;&#44; without the canal fracture being associated with any TBF pattern&#46; This event is of clinical relevance&#44; since it suggests the most probable origin of otorrhagia in a patient who has suffered a HT is an EAC fracture&#44; regardless of the radiological TBF pattern&#46; Clinical examination will lead to the observation of an interval with discontinuity of skin&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Within hearing loss-associated fractures&#44; 83&#46;3&#37; of the longitudinal fractures presented with conductive hearing loss and 90&#46;9&#37; of the transversal fractures had sensorineural hearing loss&#44; with statistical significance &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;001&#41;&#46; Based on these results&#44; we could predict the type of hearing loss a patient with hearing impairment would have after a TBF&#44; depending on the type of fracture&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Not all results from the symptoms and signs associated with TBF corresponded with that generally accepted&#58; facial paralysis was most frequently detected in longitudinal fractures&#44; EAC involvement presented with the same frequency in longitudinal fractures as in transversal ones and otorragia was identified in most transversal fracture cases&#46; We did coincide in that when facial paralysis spread in transversal fractures&#44; it was more serious&#44; requiring surgical treatment in this case&#46; This discrepancy in results highlighted that the traditional classification of the TBF is more academic than clinical&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Importance of the New Classifications</span><p id="par0195" class="elsevierStylePara elsevierViewall">The manifestations traditionally associated with transversal fractures only match this pattern if we accept that the fracture line crosses the otic capsule&#44; but this association is not always the norm and it makes no sense to speak of transversal fractures without knowing which structures crosses the fracture line&#46; Also&#44; the traditional classification has the limitation that it is difficult to define fractures as longitudinal or transversal&#44; since the fracture line rarely follows a pure pathway&#46; Even the introduction of the term mixed fracture did not solve this problem&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> We believe that this classification would be useful as a method of approximation to the TBF because it provides a good spatial idea of the fracture line&#44; but its usefulness is more academic than practical in the clinical field&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Among the alternative classifications for assessing TBF&#44; the classification based on involvement or preservation of the otic capsule has gainedrelevance during recent years&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> The otic capsule is the bony region of the inner ear which covers the membranous labyrinth of the cochlear and the vestibular system&#46; The estimated frequency of this type of fracture is 2&#46;5&#37;&#8211;8&#46;5&#37;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and it is related to a higher presence of facial paralysis&#44; CSF fistula and sensorineural hearing loss&#46; This classification has proven to have a better correlation between radiological findings and clinical manifestations than the standard classification&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">In concordance with data published by other authors&#44; the frequency of fractures with otic capsule involvement was 8&#46;2&#37;&#46; This was identified more often in transversal fractures&#46; Involvement of the otic capsule showed significant association with sensorineural hearing loss &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;003&#41;&#44; cophosis &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41;&#44; facial paralysis &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;03&#41; and vertigo &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;03&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">In keeping with these results and with those of other authors&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> we believe the involvement of the otic capsule is a better predictor of severe lesions and potential sequelae in TBF&#46; It has the limitation that otic capsule involvement is a rare event&#44; and therefore this classification does not provide as much information in cases where it has been preserved&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">We believe the best method for undertaking TBF diagnosis would be a combination of both approaches&#46; The traditional classification provides information on the direction of the fracture and on certain clinical characteristics such as the type of hearing loss&#46; However&#44; if we combine this with otic capsule involvement specification&#44; the predictive power of secondary clinical fracture symptoms is much greater due to its significant association with sensorineural hearing loss&#44; cophosis&#44; facial paralysis and vertigo&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Mastoid Pneumatisation</span><p id="par0220" class="elsevierStylePara elsevierViewall">Another element which may impact the severity of the TBF is the pneumatisation of the temporal bone&#46; The pneumatised areas are regions of the least resistance which encourages the appearance of pathologies such as cholesteatoma&#44; otitis media and cholesterol granuloma<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> and CSF fistulas after surgical interventions of the skull base&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> However&#44; the studies undertaken in relation to the TBF attribute pneumatisation with a protective function due to its capacity to absorb the energy of the impact produced by trauma&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">The study of pneumatisation of the temporal bone is complex due to the irregularity of the anatomy of the bone and the difficulty in establishing a reproducible classification method&#46; In this study classification of apex pneumatisation of the petrous bone used related to the vertical section of the internal carotid artery<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and pneumatisation of the mastoids to the sigmoid sinus&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> both based on axial slices in the CT imaging&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">These classifications establish the different degrees of pneumatisation depending on the cells visualised in a single slice&#44; and the information collected by each one is therefore limited&#46; However&#44; use of both together provides a better idea of the overall pneumatisation of the temporal bone&#44; because with the first classification we would be assessing a more cranial and lateral section and with the second a more medial and caudal section with which we gain information about pneumatisation at different levels of height and depth&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">In studies conducted on the prevalence of different degrees of pneumatisation&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> it was found that the most common level of pneumatisation of the petrous apex is usually partial&#44; whilst that of the mastoids is usually hyperpneumatisised&#46; The results of our study also show a greater prevalence of groups with higher pneumatisation&#46; The most common group in pneumatisation of the apex was the group of partial pneumatisation &#40;49&#46;1&#37;&#41; and in mastoid pneumatisation it was that of good pneumatisation &#40;42&#46;7&#37;&#41;&#44; with hyper pneumatisation ranking second &#40;30&#46;9&#37;&#41;&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">In the study by Kang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> based on CT imaging reviews they found that the higher the pneumatisation the lower the otic capsule involvement&#44; and that this was statistically significat&#44; according to the mastoid pneumatisation classification&#44; although not with the apex pneumatisation classification&#44; and the lower the severity of secondary hearing loss to the fracture &#40;this outcomes was statistically significant according to both classifications&#41;&#46; They concluded that the degree of pneumatisation of the temporary bone has a negative correlation with the rate of otic capsule involvement and the severity of hearing loss in patients with TBF&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">Ilea ET al&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;25</span></a> undertook studies with an exhaustive analysis of temporal bone pneumatisation&#44; finding significant association between lower pneumatisation and greater EAC and middle ear lesions&#46; The involvement of the otic capsule was also more common in the poorly pneumatised temporal bones but no statistical significance was determined&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">The results obtained from our study show a higher frequency of fractures in patients with greater pneumatisation&#44; both in the apex pneumatisation classification and in the mastoid pneumatisation classification&#46; There was a tendency for higher involvement of the otic capsule with greater pneumatisation according to both classifications&#44; with statistical significance with very good mastoid pneumatisation &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;024&#41; and complete apex pneumatisation &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;003&#41;&#46; According to our results&#44; good pneumatisation of the temporal bone would not be a protective factor for fractures as had been previously suggested&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;25</span></a> The low number of cases with otic capsule involvement in the sample and the fact that the most prevalent groups in the general population were those of greater pneumatisation is a study limitation&#44; as is the use of classifications based on a single CT imaging slice&#44; because even with their combined use much information on overall pneumatisation of the bone would still require collection&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conclusions</span><p id="par0255" class="elsevierStylePara elsevierViewall">From the results obtained from this study we may conclude that&#58;</p><p id="par0260" class="elsevierStylePara elsevierViewall">The traditional classification of the radiological pattern of longitudinal&#44; transversal and mixed fractures is easily reproducible&#44; and has good interobserver concordance&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">The association of the traditional classification with clinical findings does not always coincide with the standard described percentages&#44; whilst the classification of fractures according to otic capsule involvement leads to better prediction of clinical manifestations&#44; such as sensorineural hearing loss&#44; vertigo and facial paralysis&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">The combination of both classifications leads to greater precision in the prediction of clinical symptoms associated with the fracture&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">In contrast to the proposal of mastoid pneumatisation being a protective factor&#44; the results from this study reveal a higher frequency of otic capsule involvement in the best pneumatised mastoids&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Financing</span><p id="par0280" class="elsevierStylePara elsevierViewall">This study did not receive any funding or grants&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of Interests</span><p id="par0285" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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            0 => "Temporal bone fracture"
            1 => "Hearing loss"
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            0 => "Fractura de hueso temporal"
            1 => "Hipoacusia"
            2 => "Tomograf&#237;a computarizada"
            3 => "Par&#225;lisis facial"
            4 => "C&#225;psula &#243;tica"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The diagnosis of temporal bone fractures &#40;TBF&#41; is based on radiological imaging&#46; The most widely used classification divides fractures into longitudinal&#44; transverse&#44; and mixed&#46; In recent years&#44; other classifications have emerged to better predict clinical manifestations&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">To review computed tomography &#40;CT&#41; images of TBF&#44; define their radiological pattern&#44; and study the concordance of the observed findings with those described in the radiological report&#46; To analyse the association between fracture types and clinical findings&#46; To study the impact of mastoid pneumatization on fracture characteristics&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of 110 TBF diagnosed with CT between January 2016 and May 2019&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Fifty-two transverse &#40;47&#37;&#41;&#44; 34 longitudinal &#40;30&#37;&#41;&#44; and 19 mixed fractures &#40;17&#37;&#41; were identified with good interobserver agreement &#40;k &#61; &#46;637&#41;&#46; Longitudinal fractures were associated with conductive hearing loss &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41; and transverse fractures with sensorineural hearing loss &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;005&#41;&#46; Of the fractures&#44; 8&#46;2&#37; showed involvement of the otic capsule&#44; and were associated with sensorineural hearing loss &#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41;&#44; facial paralysis &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;019&#41; and vertigo &#40;<span class="elsevierStyleItalic">P</span>&#61; &#46;035&#41;&#46; Fractures were more frequent in cases of greater pneumatization&#44; and the involvement of the otic capsule in cases of very good pneumatization &#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;024&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">The traditional classification of TBF is reproducible&#46; Its association with clinical findings improves when the involvement of the otic capsule is also analysed&#46; Mastoid pneumatization is not a protective factor for TBF or for involvement of the otic capsule&#46;</p></span>"
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          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
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          1 => array:2 [
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            "titulo" => "Objectives"
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          2 => array:2 [
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">El diagn&#243;stico de las fracturas del hueso temporal &#40;FHT&#41; se basa en la imagen radiol&#243;gica&#46; La clasificaci&#243;n m&#225;s utilizada divide las fracturas en longitudinales&#44; transversales y mixtas&#46; En los &#250;ltimos a&#241;os han surgido otras clasificaciones con el objeto de predecir mejor las manifestaciones cl&#237;nicas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Revisar las im&#225;genes de tomograf&#237;a computarizada &#40;TC&#41; del hueso temporal&#44; definir su patr&#243;n radiol&#243;gico seg&#250;n la clasificaci&#243;n tradicional y estudiar la concordancia interobservador de los hallazgos observados con los descritos en el informe radiol&#243;gico&#46; Analizar la asociaci&#243;n entre los tipos de fractura y los hallazgos cl&#237;nicos&#46; Estudiar el impacto de la neumatizaci&#243;n mastoidea en las caracter&#237;sticas de la fractura&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiales y m&#233;todos</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de 110 FHT diagnosticadas mediante TC entre enero de 2016 y mayo 2019&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 52 fracturas transversales &#40;47&#37;&#41;&#44; 34 longitudinales &#40;30&#37;&#41; y 19 mixtas &#40;17&#37;&#41; con buena concordancia interobservador &#40;k &#61; 0&#44;637&#41;&#46; Las fracturas longitudinales se asociaron con hipoacusia de transmisi&#243;n &#40;<span class="elsevierStyleItalic">P</span> &#60;0&#44;001&#41; y las transversales con hipoacusia neurosensorial &#40;<span class="elsevierStyleItalic">P</span> &#61;0&#44;005&#41;&#46; El 8&#44;2&#37; de las fracturas presentaron afectaci&#243;n de c&#225;psula &#243;tica y se asociaron con hipoacusia neurosensorial &#40;<span class="elsevierStyleItalic">P</span> &#60;0&#44;001&#41;&#44; par&#225;lisis facial &#40;<span class="elsevierStyleItalic">P</span> &#61;&#44;019&#41; y v&#233;rtigo &#40;<span class="elsevierStyleItalic">P</span> &#61;&#44;035&#41;&#46; Las fracturas fueron m&#225;s frecuentes en los casos de mayor neumatizaci&#243;n&#44; y la afectaci&#243;n de c&#225;psula &#243;tica en casos de muy buena neumatizaci&#243;n &#40;<span class="elsevierStyleItalic">P</span> &#61;&#44;024&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">La clasificaci&#243;n tradicional de las FHT es reproducible&#46; Su asociaci&#243;n con los hallazgos cl&#237;nicos mejora cuando se analiza adem&#225;s la afectaci&#243;n de la c&#225;psula &#243;tica&#46; La neumatizaci&#243;n mastoidea no es un factor protector para las FHT ni para la afectaci&#243;n de la c&#225;psula &#243;tica&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Morales Puebla JM&#44; L&#243;pez Juanes N&#44; Varo Alonso M&#44; S&#225;nchez Cuadrado I&#44; Gavil&#225;n Bouzas J&#44; Lassaletta Atienza L&#46; Correlaci&#243;n cl&#237;nico-radiol&#243;gica de las fracturas de hueso temporal&#46; Acta Otorrinolaringol Esp&#46; 2021&#59;72&#58;295&#8211;304&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Types of TBF according to the standard classification&#46; A&#41; Longitudinal fracture&#46; B&#41; Transversal fracture with no otic capsule involvement&#46; C&#41; Mixed&#46; D&#41; Transversal fracture with otic capsule involvement&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Images of the right ear&#59; arrows&#44; fracture line&#44; discontinuous line&#58; greater petrous bone axis&#46;</p>"
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            "identificador" => "at0015"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Results from the interobserver concordance &#40;kappa&#41; of the types of fracture according to anatomophysiopathological classification&#46;</p>"
        ]
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Frequence of the observed clinical manifestations and of every type of associated TBF &#40;results obtained after review of the images&#44; in percentages&#41;&#46;</p>"
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      ]
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        "identificador" => "fig0025"
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Results regarding the prevalence of the different types of pneumatisation in keeping with each classification in percentages&#46;</p>"
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          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">EAC&#58; External auditory canal&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Modified from&#58; Varo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Longitudinal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hearing loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Conductive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sensorineural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Otorrhagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rare&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haemotympanum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rare&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eardrum perforation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rare&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EAC involvement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequent &#40;in interval&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rare&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cerebrospinal fluid otorrhagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rare&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Facial paralysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Temporal &#40;10&#37;&#8211;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Permanent &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vertigo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rare and mild &#40;positional&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequent and severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Clinical Manifestations of TBF According to the Standard Classification&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Demographic Data&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age &#40;Paediatric &#8804;16 Years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aetiology of trauma&#58; fall&#44; traffic accident&#44; aggression&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="7" align="left" valign="middle">Radiological data</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Type of fracture according to the radiological report&#58; longitudinal&#44; transversal&#44; mixed&#44; unspecified type&#44; suspicion from indirect signs&#44; fracture not described&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Type of fracture according to imaging review&#58; longitudinal&#44; transversal&#44; mixed&#44; with no fracture observation&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EAC involvement&#58; yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ossicicular chain involvement&#58; yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Otic capsule involvement&#58; yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mastoid pneumatisation<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#58; poor&#44; moderate&#44; good&#44; very good&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apex pneumatisation<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#58; none&#44; partial&#44; complete&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="9" align="left" valign="middle">Clinical data</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Changes to hearing&#58; normal hearing&#44; conductive hearing loss&#44; sensorineural hearing loss &#40;includes mixed and cophosis&#41;&#44; cophosis&#44; not assessable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Otorrhagia&#58; Yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eardrum perforation&#58; Yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haemotypanum&#58; Yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Facial paralysis&#58; Yes&#44; no&#44; not appreciable s&#237;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Resolution of facial paralysis&#58; spontaneous&#44; surgery&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vertigo&#58; Yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cerebrospinal fluid otorrhagia&#58; Yes&#44; no&#44; not appreciable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Death&#58; Yes&#44; no&#44;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2693316.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Variables Studied&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0040"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">IS &#61; Indirect signs&#59; L &#61; Longitudinal&#46; M &#61; Mixed&#44; NV &#61; Not appreciable T &#61; Transversal&#59; V &#61; Appreciable&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Radiological Reports</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Image Review</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Unspecified Type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Suspected Due to ISI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No Fracture Observed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Otic Capsule Involvement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TotalN &#61; 110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;9&#37;n &#61; 34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;8&#37;n &#61; 35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;7&#37;n &#61; 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;1&#37;n &#61; 21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5&#37;n &#61; 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;9&#37;n &#61; 34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;3&#37;n &#61; 52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;3&#37;n &#61; 19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;5&#37;n &#61; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;2&#37;n &#61; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EAC involvementV&#58; 108 &#40;98&#46;2&#37;&#41;NV&#58; 2 &#40;1&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;5&#37;n &#61; 49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;8&#37;n &#61; 18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;4&#37;n &#61; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;3&#37;n &#61; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;5&#37;n &#61; 13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;7&#37;n &#61; 18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;7&#37;n &#61; 18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;6&#37;n &#61; 13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;2&#37;n &#61; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ossicular chain involvementV&#58; 94 &#40;85&#46;5&#37;&#41;NV&#58; 16 &#40;14&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;2&#37;n &#61; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;4&#37;n &#61; 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2&#37;n &#61; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2&#37;n &#61; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2&#37;n &#61; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;5&#37;n &#61; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2&#37;n &#61; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;3&#37;n &#61; 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;1&#37;n &#61; 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">OtorrhagiaV&#58; 106 &#40;96&#46;4&#37;&#41;NV&#58; 4 &#40;3&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;8&#37;n &#61; 46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;1&#37;n &#61; 18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;9&#37;n &#61; 11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;8&#37;n &#61; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;2&#37;n &#61; 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;8&#37;n &#61; 16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#37;n &#61; 17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;2&#37;n &#61; 13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;2&#37;n &#61; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eardrum perforation V&#58; 39 &#40;35&#46;5&#37;&#41;NV&#58; 71 &#40;64&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20&#37;n &#61; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">HaemotympanumV&#58; 42 &#40;38&#46;2&#37;&#41;NV&#58; 68 &#40;61&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">10&#46;9&#37;n &#61; 12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41&#46;7&#37;n &#61; 5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16&#46;7&#37;n &#61; 2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Conductive hearing lossV&#58; 52 &#40;47&#46;3&#37;&#41;NV&#58; 58 &#40;52&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">66&#46;7&#37;n &#61; 8&#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;022&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">83&#46;4&#37;n &#61; 10&#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#46;3&#37;n &#61; 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#37;n &#61; 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sensorineural hearing lossV&#58; 52 &#40;47&#46;3&#37;&#41;NV&#58; 58 &#40;52&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">13&#46;6&#37;n &#61; 15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">46&#46;7&#37;n &#61; 7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66&#46;7&#37;n &#61; 10&#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;005&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20&#37;n &#61; 3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53&#46;3&#37;n &#61; 8&#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;003&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">CophosisV&#58; 52 &#40;47&#46;3&#37;&#41;NV&#58; 58 &#40;52&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#46;1&#37;n &#61; 10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60&#37;n &#61; 6&#40;<span class="elsevierStyleItalic">P</span> &#61; &#46;039&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">80&#37;n &#61; 8&#40;<span class="elsevierStyleItalic">P</span> &#60; &#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Facial paralysisV&#58; 92 &#40;83&#46;6&#37;&#41;NV&#58; 18 &#40;16&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33&#46;3&#37;n &#61; 3&nbsp;\t\t\t\t\t\t\n
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                        "paginaInicial" => "188"
                        "paginaFinal" => "197"
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                        "tituloSerie" => "Biometrics&#46;"
                        "fecha" => "1977"
                        "volumen" => "33"
                        "paginaInicial" => "159"
                        "paginaFinal" => "174"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Using temporal bone computed tomography to predict sensorineural hearing loss in otic capsule-sparing temporal bone fracture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;K&#46; Mun"
                            1 => "K&#46;H&#46; Oh"
                            2 => "Y&#46;H&#46; Hong"
                            3 => "H&#46;J&#46; Min"
                            4 => "K&#46;S&#46; Kim"
                            5 => "S&#46;Y&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Injury&#46;"
                        "fecha" => "2017"
                        "volumen" => "48"
                        "paginaInicial" => "2879"
                        "paginaFinal" => "2883"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temporal bone fracture&#58; Evaluation in the era of modern computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;D&#46; Schubl"
                            1 => "T&#46;R&#46; Klein"
                            2 => "R&#46;J&#46; Robitsek"
                            3 => "S&#46; Trepeta"
                            4 => "K&#46; Fretwell"
                            5 => "D&#46; Seidman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.injury.2016.06.026"
                      "Revista" => array:7 [
                        "tituloSerie" => "Injury&#46;"
                        "fecha" => "2016"
                        "volumen" => "47"
                        "paginaInicial" => "1893"
                        "paginaFinal" => "1897"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27387791"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S092375341931083X"
                          "estado" => "S300"
                          "issn" => "09237534"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multidetector CT of temporal bone fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Collins"
                            1 => "A&#46;K&#46; Krishnamoorthy"
                            2 => "W&#46;S&#46; Kubal"
                            3 => "M&#46;H&#46; Johnson"
                            4 => "C&#46;S&#46; Poon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Seminars Ultrasound CT MR&#46;"
                        "fecha" => "2012"
                        "volumen" => "33"
                        "paginaInicial" => "418"
                        "paginaFinal" => "431"
                        "itemHostRev" => array:3 [
                          "pii" => "S155608641930454X"
                          "estado" => "S300"
                          "issn" => "15560864"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High resolution CT scan of temporal bone fractures&#58; association of facial nerve paralysis with temporal bone fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46;A&#46; Aguilar 3rd"
                            1 => "J&#46;W&#46; Yeakley"
                            2 => "B&#46;Y&#46; Ghorayeb"
                            3 => "M&#46; Hauser"
                            4 => "J&#46; Cabrera"
                            5 => "R&#46;A&#46; Jahrsdoerfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Head Neck Surg&#46;"
                        "fecha" => "1987"
                        "volumen" => "9"
                        "paginaInicial" => "162"
                        "paginaFinal" => "166"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temporal bone fractures&#58; longitudinal or oblique&#63; The case for oblique temporal bone fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;Y&#46; Ghorayeb"
                            1 => "J&#46;W&#46; Yeakley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1288/00005537-199202000-00005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope&#46;"
                        "fecha" => "1992"
                        "volumen" => "102"
                        "paginaInicial" => "129"
                        "paginaFinal" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1738283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temporal bone fractures&#58; otic capsule sparing versus otic capsule violating clinical and radiographic considerations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Dahiya"
                            1 => "J&#46;D&#46; Keller"
                            2 => "N&#46;S&#46; Litofsky"
                            3 => "P&#46;E&#46; Bankey"
                            4 => "L&#46;J&#46; Bonassar"
                            5 => "C&#46;A&#46; Megerian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00005373-199912000-00014"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Trauma&#46;"
                        "fecha" => "1999"
                        "volumen" => "47"
                        "paginaInicial" => "1079"
                        "paginaFinal" => "1083"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10608536"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of Temporal Bone Fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;C&#46; Diaz"
                            1 => "B&#46; Cervenka"
                            2 => "H&#46;A&#46; Brodie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurolog Surg B&#44; Skull Base&#46;"
                        "fecha" => "2016"
                        "volumen" => "77"
                        "paginaInicial" => "419"
                        "paginaFinal" => "429"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiographic classification of temporal bone fractures&#58; clinical predictability using a new system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;C&#46; Little"
                            1 => "B&#46;W&#46; Kesser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archotol.132.12.1300"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg&#46;"
                        "fecha" => "2006"
                        "volumen" => "132"
                        "paginaInicial" => "1300"
                        "paginaFinal" => "1304"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17178939"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification of temporal bone pneumatization on high-resolution computed tomography&#58; prevalence patterns and implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Dexian Tan"
                            1 => "J&#46;H&#46; Ng"
                            2 => "S&#46;A&#46; Lim"
                            3 => "D&#46;Y&#46; Low"
                            4 => "H&#46;W&#46; Yuen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Otolaryngolo Head Neck Surg&#46;"
                        "fecha" => "2018"
                        "volumen" => "159"
                        "paginaInicial" => "743"
                        "paginaFinal" => "749"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petrous bone pneumatization is a risk factor for cerebrospinal fluid fistula following vestibular schwannoma surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;H&#46; Stieglitz"
                            1 => "M&#46; Giordano"
                            2 => "V&#46; Gerganov"
                            3 => "A&#46; Raabe"
                            4 => "A&#46; Samii"
                            5 => "M&#46; Samii"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/NEU.0b013e3181f88884"
                      "Revista" => array:7 [
                        "tituloSerie" => "Neurosurgery&#46;"
                        "fecha" => "2010"
                        "volumen" => "67"
                        "numero" => "2 Suppl Operative"
                        "paginaInicial" => "509"
                        "paginaFinal" => "515"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21099580"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of mastoid pneumatization in temporal bone fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Ilea"
                            1 => "A&#46; Butnaru"
                            2 => "S&#46;A&#46; Sfr&#226;ngeu"
                            3 => "M&#46; Hede&#351;iu"
                            4 => "C&#46;M&#46; Dudescu"
                            5 => "P&#46; Berce"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3174/ajnr.A3887"
                      "Revista" => array:7 [
                        "tituloSerie" => "AJNR Am J Neuroradiol&#46;"
                        "fecha" => "2014"
                        "volumen" => "35"
                        "paginaInicial" => "1398"
                        "paginaFinal" => "1404"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24610903"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S014067361632517X"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and characteristics of pneumatization of the temporal bone evaluated by cone beam computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;B&#46; Ladeira"
                            1 => "G&#46;L&#46; Barbosa"
                            2 => "M&#46;C&#46; Nascimento"
                            3 => "A&#46;D&#46; Cruz"
                            4 => "D&#46;Q&#46; Freitas"
                            5 => "S&#46;M&#46; Almeida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijom.2012.12.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Oral Maxillofac Surg&#46;"
                        "fecha" => "2013"
                        "volumen" => "42"
                        "paginaInicial" => "771"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23290566"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The potential protective effects of temporal bone pneumatization&#58; A shock absorber in temporal bone fracture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;K&#46; Kang"
                            1 => "R&#46; Ha"
                            2 => "J&#46;H&#46; Oh"
                            3 => "W&#46; Sunwoo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0227202"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2019"
                        "volumen" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31891643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temporal bone trauma effects on auditory anatomical structures in mastoid obliteration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Ilea"
                            1 => "A&#46; Butnaru"
                            2 => "S&#46;A&#46; Sfr&#226;ngeu"
                            3 => "M&#46; Hede&#537;iu"
                            4 => "C&#46;M&#46; Dudescu"
                            5 => "B&#46;A&#46; Bo&#537;ca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00405-018-5227-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Arch Otorhinolaryngol&#46;"
                        "fecha" => "2019"
                        "volumen" => "276"
                        "paginaInicial" => "513"
                        "paginaFinal" => "520"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30506431"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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Article information
ISSN: 21735735
Original language: English
DOI:10.1016/j.otoeng.2020.09.003
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