The relative frequencies of temporal bone fractures have commonly been reported as 70-90% longitudinal and 10-30% transverse, although it has been noted that mixed fractures may be the most common fracture type [3, 4].Ishman et al. Technologic advances have enabled timely acquisition of thin-section images and multiplanar reconstructions such that temporal bone anatomy can be evaluated in great detail, with excellent delineation of fractures. Most common Mastoidectomy (55%) Tplasty (14%), Bony exostoses (14% . Unexpectedly, the . The detection and classification of temporal bone fractures, their distinction from pseudofractures, and the role of imaging in establishing prognosis are discussed, particularly with respect to complications. Lateral impact injuries to the temporal bone are mostly responsible for these fractures - impacts involving the mastoid or the squamous temporal bone. The fracture line parallels the long axis of the petrous pyramid. While many blunt injuries may be managed conservatively, penetrating fractures, such as gunshot wounds, warrant a lower threshold for surgical intervention. Mai Temporal bone fractures. Complications of temporal bone fractures include facial nerve palsy, cerebrospinal fluid leakage, conductive hearing loss, sensorineural hearing loss, and vertigo. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Complications evaluated included facial nerve paresis or paralysis, SNHL, CHL, dizziness or balance dysfunction, and CSF leakage. Temporal bone trauma is frequently encountered in the emergency department. Ishman SL, Friedland DR. Pertinent physical findings were hemotympanum, bloody otorrhea, tympanic membrane . Evaluation of 123 cases]. clear fluid leaking from . Twenty-three such lesions were demonstrated by combined axial and coronal HRCT; 22 lesions of the facial canal could be demonstrated in 27 patients presenting with facial nerve palsy. The most common site of injury to the facial nerve in 10 transverse and 30 longitudinal fractures of the temporal bone has been found within the labyrinthine segment of the Fallopian canal. The frequency of skull base fractures varies from 5% to 14% in children with head injuries, with a high prevalence of the temporal bone (as high as 62%), followed by the occipital, sphenoidal, and sphenoethmoidal . [] simply distinguish petrous from non-petrous fractures and they noticed that it is far better correlation with respect to facial nerve weakness, cerebrospinal . •. The skull has been biomechanically adapted to resist extreme amounts of force relative to the appendicular skeleton, 1 and the temporal bone is not an exception, with estimates of 1875 pounds of lateral impact required to generate a fracture within cadaveric temporal . . This places them on the outside of the temporal lobe of the cerebral cortex, ensuring that the skull is properly supported and protecting the vital structures there. Classification Carotid artery injury is seen in 2-35% of patients with BSF 32,33. The prognoses of common temporal bone fracture complications are as follows: Facial nerve paralysis: Partial and/or delayed facial paralysis has an overall favorable prognosis with conservative treatment only. Temporal bone fractures are a common lesion of the base of the skull. The temporal bone is involved in 75% of cases, but the occipital, sphenoid, and ethmoid bones may also be involved. Linear fractures are the most common, followed by depressed and basilar skull fractures. . Various classification schemes have been proposed, with those identifying critical structures being more useful. Coronal FS-T2WI may be more useful to detect and characterize these fractures than other . Unusual Complications of Temporal Bone Fractures Bechara Y. Ghorayeb, MD; Joel W. Yeakley, MD; James W. Hall III, PhD; B. Eric Jones \s=b\Eighty-two temporal bone fractures were diagnosed in 75 patients with high- resolution computed tomographic scan- ning. bleeding from a wound. Introduction: Zygomatic bone is closely associated with the maxilla, frontal, temporal bones which are usually involved when a zygomatic bone fracture occurs. Twenty-three such lesions were demonstrated by combined axial and coronal HRCT; 22 lesions of the facial canal could be demonstrated in 27 patients presenting with facial nerve palsy. 1. The overall prevalence of PTB fractures in paediatric patients who presented with a skull fracture was 7% in this study. The most common cause of a temporal bone fracture was traffic accident. Introduction. The exception is severe bleeding from the external auditory meatus which may represent jugular bulb or carotid artery injury - this is exceedingly rare . . Pertinent physical findings were hemotympanum, bloody otorrhea, tympanic membrane . Conductive hearing loss that persists >6 weeks post-injury is often due to ossicular chain pathology after resolution of blood or cerebrospinal fluid within the middle ear. Consider high resolution CT temporal bones . For the assessment of temporal fractures, cranial CT is a fundamental and initial diagnostic modality. Simply stated, a basilar skull fracture refers to any fracture found at the base of the skull. Temporal Bone Trauma. Variable clinical presentations may arise from such fractures, ranging from an asymptomatic course to very serious consequences. Temporal bone injury is frequently associated with severe brain injury which limits the clinical evaluation and detracts from the clinical signs of temporal bone fracture such as sensorineural hearing loss, conductive hearing loss, and facial nerve paralysis. . Twenty-one patients (49%) presented with decreased mental status. Most cases of temporal bone fracture involve severe body and/or head trauma. As a result, blunt trauma or fractures to these bones can lead to serious . These fractures most frequently occur after a severe blow to the occipital or frontal region. . Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. Temporal bone injury is a condition associated with significant morbidity, the prompt recognition of which may aid recovery. The Longitudinal Fractures: These are the most common temporal bone fractures comprising about 80% of all the frac-tures [6]. Fortunately the nerve is fairly robust and has a good regenerative response to mechanical injury. Management of complications from 820 temporal bone fractures. The aim of this study was to report our experience with a series of patients with temporal bone . Temporal bone fractures can cause various injuries to the middle and . Helical CT as performed in a trauma setting tifywill idenover 98% temporal bone fractures3; high-resolution dedicated CT of the temporal bones is in dicated particularly where there are complication s in order to precisely delineate the fracture line, or where a fracture is clinically suspected but not Significant alcohol and drug use was documented in 28% and 58% of patients, respectively. The number of temporal bone fractures increased from 6 in 1992 to 21 in 1994. The most common complication associated with temporal bone fractures is ossicular injury resulting in variable hearing loss. It is composed of the temporal, occipital . (<10% of temporal bone fractures) unless there has been a penetrating injury, in which case the frequency rises . The diagnosis of dizziness or balance dysfunction was made on patient self-reporting. 1 Temporal bone fractures occur in 18-40% of all skull fractures. Basilar skull fractures most commonly involve the temporal bones but may involve the occipital, sphenoid, ethmoid, and the orbital plate of the frontal bone as well. volume of force is required to fracture the temporal bone. Transverse fractures account for 20 to 30% of temporal bone injuries. SIF is a common complication in cervical cancer after radiotherapy, which has some certain clinical and MRI features. The most common cause of a temporal bone fracture was traffic accident. 1-3 Compared with the malleoincudal joint, . A dedicated high-resolution CT of the temporal bones demonstrated bilateral longitu-dinal and obliquely orientated temporal bone fractures with the fracture line crossing the In young men, these fractures are usually a result of high-energy trauma while in the older population, this fracture is seen in women after a ground-level fall. Edwin Y. Wang, Deborah Shatzkes and Joel D. Swartz. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common, surgically treatable complication of temporal bone fracture is disruption of the ossicular chain. Before the development of high-resolution multidetector computed tomography (MDCT) imaging, fractures of the . A basilar skull fracture, or skull base fracture, is a type of traumatic head injury that involves a break in at least one of the bones at the base of the skull. Temporal bone fractures have little ability to form a ''callus.'' Tendency for squamous invasion at the fracture site Acquired cholesteatoma is a potential delayed complication Longitudinal fractures are best diagnosed with CT. MR imaging manifestations of this type of fracture include dural enhancement, believed to correlate with . The symptoms of a skull fracture may include: a headache or pain at the point of impact. Conflicts of interest There are no conflicts of interest. Basilar skull fractures, usually caused by substantial blunt force trauma, involve at least one of the bones that compose the base of the skull. Diagnosis relies primarily on physical signs and symptoms as well as radiographic imaging. Skull fracture. CT remains the imaging modality of choice. A 24-year-old man sustained significant injuries as a result of a motor bicycle accident. It contains the middle and inner portions of the ear, and is crossed by the majority of the cranial nerves. The evaluation of the . Overview-Complications. . Conductive hearing loss is a well-known complication of temporal bone fractures and results in significant morbidity for patients. The most common causes of these . Temporal bones are the thickest skull base bones and require a great force to fracture. A temporal bone fracture may cause facial paralysis, hearing loss, bruising behind the ear, and bleeding from the ear. Out of which CHL was more common than mixed loss and mixed loss was most commonly associated with OCV fractures. Usually, the nose looks deformed or feels sore to . Doctors use computed tomography (CT) to diagnose temporal bone fractures. 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