Classification Of Plfs

A myriad of different etiologies for PLFs have been described in the literature. To simplify this discussion, we suggest a global classification of PLF etiology: (1) pathologic (e.g., cholesteatoma, infection/erosion, tumors); (2) traumatic (e.g., acoustic, blast or barotrauma, surgical complication); and (3) spontaneous (idiopathic) (Table 55-1).

We have encountered a wide array of interesting causes of PLFs, including PLFs that resulted from prolonged vomiting after exposure to toxic fumes, PLFs in a young weightlifter, PLFs developing during labor and delivery, and PLFs that occurred after a frozen 24-lb turkey fell from a freezer on a patient's head. In our experience, trauma to the head and neck is by far the most common cause of PLFs. However, our experience is heavily weighted toward trauma patients. There are

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