The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture
We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF). Cha...
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| description | We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF).
Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction.
Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025).
The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs. |
| doi_str_mv | 10.1371/journal.pone.0217682 |
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Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction.
Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025).
The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0217682</identifier><identifier>PMID: 31150482</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Biology and Life Sciences ; Bones ; Classification ; Classification systems ; Cochlea - physiopathology ; Complications ; Computed tomography ; Correlation analysis ; Facial nerve ; Facial Nerve - diagnostic imaging ; Facial Nerve - physiopathology ; Facial Paralysis - diagnostic imaging ; Facial Paralysis - physiopathology ; Female ; Fractures ; Fractures, Bone - diagnostic imaging ; Fractures, Bone - physiopathology ; Head injuries ; Hearing loss ; Hearing Loss - diagnostic imaging ; Hearing Loss - etiology ; Hearing Loss - physiopathology ; Hearing Loss, Sensorineural - diagnostic imaging ; Hearing Loss, Sensorineural - etiology ; Hearing Loss, Sensorineural - physiopathology ; Humans ; Impact loads ; Male ; Mastoid - physiopathology ; Medical prognosis ; Medical records ; Medicine and Health Sciences ; Middle Aged ; Otolaryngology ; Otology ; Paralysis ; Prenatal development ; Shock absorbers ; Skull Fractures - diagnostic imaging ; Skull Fractures - physiopathology ; Studies ; Surgery ; Temporal bone ; Temporal Bone - diagnostic imaging ; Temporal Bone - physiopathology ; Tomography, X-Ray Computed ; Trauma ; Vertigo ; Vertigo - diagnostic imaging ; Vertigo - physiopathology ; Vestibular system ; Volumetric analysis</subject><ispartof>PloS one, 2019-05, Vol.14 (5), p.e0217682-e0217682</ispartof><rights>2019 Kang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Kang et al 2019 Kang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-afd5b2e1ddf9f7841c6375eff1db0de9431a48eaf8ea530cfe2bb21236defe153</citedby><cites>FETCH-LOGICAL-c526t-afd5b2e1ddf9f7841c6375eff1db0de9431a48eaf8ea530cfe2bb21236defe153</cites><orcidid>0000-0002-0259-8654</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544272/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544272/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31150482$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Agarwal, Suresh</contributor><creatorcontrib>Kang, Tae Kyu</creatorcontrib><creatorcontrib>Ha, Ryun</creatorcontrib><creatorcontrib>Oh, Jae Hwan</creatorcontrib><creatorcontrib>Sunwoo, Woongsang</creatorcontrib><title>The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF).
Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction.
Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025).
The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs.</description><subject>Adult</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Bones</subject><subject>Classification</subject><subject>Classification systems</subject><subject>Cochlea - physiopathology</subject><subject>Complications</subject><subject>Computed tomography</subject><subject>Correlation analysis</subject><subject>Facial nerve</subject><subject>Facial Nerve - diagnostic imaging</subject><subject>Facial Nerve - physiopathology</subject><subject>Facial Paralysis - diagnostic imaging</subject><subject>Facial Paralysis - physiopathology</subject><subject>Female</subject><subject>Fractures</subject><subject>Fractures, Bone - diagnostic imaging</subject><subject>Fractures, Bone - physiopathology</subject><subject>Head injuries</subject><subject>Hearing loss</subject><subject>Hearing Loss - diagnostic imaging</subject><subject>Hearing Loss - etiology</subject><subject>Hearing Loss - physiopathology</subject><subject>Hearing Loss, Sensorineural - diagnostic imaging</subject><subject>Hearing Loss, Sensorineural - etiology</subject><subject>Hearing Loss, Sensorineural - physiopathology</subject><subject>Humans</subject><subject>Impact loads</subject><subject>Male</subject><subject>Mastoid - physiopathology</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Otolaryngology</subject><subject>Otology</subject><subject>Paralysis</subject><subject>Prenatal development</subject><subject>Shock absorbers</subject><subject>Skull Fractures - diagnostic imaging</subject><subject>Skull Fractures - physiopathology</subject><subject>Studies</subject><subject>Surgery</subject><subject>Temporal bone</subject><subject>Temporal Bone - diagnostic imaging</subject><subject>Temporal Bone - physiopathology</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Vertigo</subject><subject>Vertigo - diagnostic imaging</subject><subject>Vertigo - physiopathology</subject><subject>Vestibular system</subject><subject>Volumetric analysis</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1rFTEUDaK0tfYfiAa6cfOe-Z48F0IpfhQKbuo6JJmbvnnOTMYkU7C_3tQ3LW1xEXLJPefcjxyE3lKypryhH3dxTqPt11McYU0YbZRmL9AR3XC2Uozwl4_iQ_Q65x0hkmulDtAhp1QSodkR6q-2gKdYYCyd7fGUauhLdwMYQqhRxjHgAsMUU027WgtPI8yDLd1tPXH8hM9w3kb_C1uXY3KQcDc-Y4RkfZkTvEGvgu0znCz3Mfr59cvV-ffV5Y9vF-dnlysvmSorG1rpGNC2DZvQaEG94o2s_dDWkRY2glMrNNhQj-TEB2DOMcq4aiEAlfwYvd_rTn3MZllUNoxxzhTjmlTExR7RRrszU-oGm_6YaDvz7yGma2NT6XwPRgtFwYNjSgehOGglPdcyeNVYEoKrWp-XarMboPV1lXXyJ6JPM2O3NdfxxigpBGtYFfiwCKT4e4ZczNBlD31vR4jzvm8t6zeKCj19Bv3_dGKP8inmnCA8NEOJuTPPPcvcmccs5qm0d48HeSDdu4X_BbWuxeE</recordid><startdate>20190531</startdate><enddate>20190531</enddate><creator>Kang, Tae Kyu</creator><creator>Ha, Ryun</creator><creator>Oh, Jae Hwan</creator><creator>Sunwoo, Woongsang</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0259-8654</orcidid></search><sort><creationdate>20190531</creationdate><title>The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture</title><author>Kang, Tae Kyu ; Ha, Ryun ; Oh, Jae Hwan ; Sunwoo, Woongsang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-afd5b2e1ddf9f7841c6375eff1db0de9431a48eaf8ea530cfe2bb21236defe153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Bones</topic><topic>Classification</topic><topic>Classification systems</topic><topic>Cochlea - physiopathology</topic><topic>Complications</topic><topic>Computed tomography</topic><topic>Correlation analysis</topic><topic>Facial nerve</topic><topic>Facial Nerve - diagnostic imaging</topic><topic>Facial Nerve - physiopathology</topic><topic>Facial Paralysis - diagnostic imaging</topic><topic>Facial Paralysis - physiopathology</topic><topic>Female</topic><topic>Fractures</topic><topic>Fractures, Bone - diagnostic imaging</topic><topic>Fractures, Bone - physiopathology</topic><topic>Head injuries</topic><topic>Hearing loss</topic><topic>Hearing Loss - diagnostic imaging</topic><topic>Hearing Loss - etiology</topic><topic>Hearing Loss - physiopathology</topic><topic>Hearing Loss, Sensorineural - diagnostic imaging</topic><topic>Hearing Loss, Sensorineural - etiology</topic><topic>Hearing Loss, Sensorineural - physiopathology</topic><topic>Humans</topic><topic>Impact loads</topic><topic>Male</topic><topic>Mastoid - physiopathology</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Otolaryngology</topic><topic>Otology</topic><topic>Paralysis</topic><topic>Prenatal development</topic><topic>Shock absorbers</topic><topic>Skull Fractures - diagnostic imaging</topic><topic>Skull Fractures - physiopathology</topic><topic>Studies</topic><topic>Surgery</topic><topic>Temporal bone</topic><topic>Temporal Bone - diagnostic imaging</topic><topic>Temporal Bone - physiopathology</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Vertigo</topic><topic>Vertigo - diagnostic imaging</topic><topic>Vertigo - physiopathology</topic><topic>Vestibular system</topic><topic>Volumetric analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kang, Tae Kyu</creatorcontrib><creatorcontrib>Ha, Ryun</creatorcontrib><creatorcontrib>Oh, Jae Hwan</creatorcontrib><creatorcontrib>Sunwoo, Woongsang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kang, Tae Kyu</au><au>Ha, Ryun</au><au>Oh, Jae Hwan</au><au>Sunwoo, Woongsang</au><au>Agarwal, Suresh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-05-31</date><risdate>2019</risdate><volume>14</volume><issue>5</issue><spage>e0217682</spage><epage>e0217682</epage><pages>e0217682-e0217682</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF).
Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction.
Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025).
The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31150482</pmid><doi>10.1371/journal.pone.0217682</doi><orcidid>https://orcid.org/0000-0002-0259-8654</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biology and Life Sciences Bones Classification Classification systems Cochlea - physiopathology Complications Computed tomography Correlation analysis Facial nerve Facial Nerve - diagnostic imaging Facial Nerve - physiopathology Facial Paralysis - diagnostic imaging Facial Paralysis - physiopathology Female Fractures Fractures, Bone - diagnostic imaging Fractures, Bone - physiopathology Head injuries Hearing loss Hearing Loss - diagnostic imaging Hearing Loss - etiology Hearing Loss - physiopathology Hearing Loss, Sensorineural - diagnostic imaging Hearing Loss, Sensorineural - etiology Hearing Loss, Sensorineural - physiopathology Humans Impact loads Male Mastoid - physiopathology Medical prognosis Medical records Medicine and Health Sciences Middle Aged Otolaryngology Otology Paralysis Prenatal development Shock absorbers Skull Fractures - diagnostic imaging Skull Fractures - physiopathology Studies Surgery Temporal bone Temporal Bone - diagnostic imaging Temporal Bone - physiopathology Tomography, X-Ray Computed Trauma Vertigo Vertigo - diagnostic imaging Vertigo - physiopathology Vestibular system Volumetric analysis |
| title | The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T23%3A02%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20potential%20protective%20effects%20of%20temporal%20bone%20pneumatization:%20A%20shock%20absorber%20in%20temporal%20bone%20fracture&rft.jtitle=PloS%20one&rft.au=Kang,%20Tae%20Kyu&rft.date=2019-05-31&rft.volume=14&rft.issue=5&rft.spage=e0217682&rft.epage=e0217682&rft.pages=e0217682-e0217682&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0217682&rft_dat=%3Cproquest_plos_%3E2233852034%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2233262380&rft_id=info:pmid/31150482&rft_doaj_id=oai_doaj_org_article_8461eceb268f463e865c385fc67a0ffb&rfr_iscdi=true |