Blood behind the eardrum typically resolves over 4 to 6 weeks
Formal hearing test will be arranged by your specialist
Dizziness and balance problems may persist for weeks
Improve gradually with time and activity
Facial weakness follow-up
Most delayed facial weakness recovers well over weeks to months
Regular follow-up appointments are important
Return to emergency immediately for any of the following
New or worsening facial drooping or weakness
Any side of the face
Difficulty closing your eye
Clear fluid draining from your ear or nose
May be cerebrospinal fluid
Fever with severe headache or neck stiffness
May indicate meningitis
Worsening headache unrelieved by prescribed medication
New weakness or numbness in your arms or legs
Confusion, unusual sleepiness, or difficulty waking
New or worsening hearing loss
Seizure or loss of consciousness
Increasing dizziness preventing standing or walking
Follow-up appointments
ENT specialist within 1 to 2 weeks
Sooner if facial weakness, CSF leak, or significant hearing loss
Audiology (formal hearing test) when ear clears
Approximately 4 to 6 weeks after injury
Neurosurgery follow-up if intracranial injury was identified
Family doctor within 1 week
References
Guidelines and key sources
Primary evidence sources
Schubl SD et al. Temporal bone fracture evaluation in the era of modern CT. Injury 2016
98.6% detection rate on routine trauma CT
Co-injury prevalence data
Zayas JO et al. Temporal bone trauma and multidetector CT in the emergency department. Radiographics 2011
CT protocol recommendations
Imaging classification review
Johnson F, Semaan MT, Megerian CA. Temporal bone fracture evaluation and management in the modern era. Otolaryngologic Clinics of North America 2008
Comprehensive management framework
ENoG surgical thresholds
Facial nerve management
Natour A et al. Temporal bone fracture related facial palsy: efficacy of decompression. Current Opinion in Otolaryngology and Head and Neck Surgery 2024
Decompression outcomes with and without grafting
Greiner RC et al. Management of facial nerve trauma. Current Opinion in Otolaryngology and Head and Neck Surgery 2024
Corticosteroid protocol evidence
Liu Y et al. Management of facial palsy after temporal bone fracture via transmastoid approach. Acta Oto-Laryngologica 2015
91.7% achieving House-Brackmann I-II with decompression within 8 weeks
Classification and outcomes
Little SC, Kesser BW. Radiographic classification of temporal bone fractures using a new system. Arch Otolaryngol Head Neck Surg 2006
Otic capsule classification validation
Wu C, He Q. Audiometric and vestibular outcomes following temporal bone fractures. Frontiers in Medicine 2025
90.4% hearing recovery in OCS at 24 months
0% recovery in OCV at 24 months
Wen CZ et al. Management of temporal bone fractures: optimizing the role of otolaryngology consultation. Otolaryngol Head Neck Surg 2026
93.5% sensitivity trigger criteria
43% reduction in inpatient ENT consults
Pediatric evidence
Poupore NS et al. Complications after pediatric temporal bone fractures. Otolaryngol Head Neck Surg 2024
Systematic review and meta-analysis
Bulut O et al. Pediatric temporal bone fractures retrospective cohort study. J Craniofacial Surgery 2026
Pediatric outcomes data
Imaging references
Kurihara YY et al. Temporal bone trauma CT and MRI appearances. Radiographics 2020
CT and MRI appearance review
Otic capsule integrity assessment
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