0:01

Let's talk a little bit more about temporal

0:03

bone fractures in general.

0:05

So you might ask what's the big importance

0:08

of temporal bone fractures? Well,

0:10

the importance of temporal bone fractures is that there are

0:13

a lot of small structures that course through the temporal

0:16

bones that may be injured at the time of trauma.

0:19

These include the small ossicles of the malleus,

0:23

the incus and the stapes.

0:24

This includes the facial nerve and leading

0:27

to potential facial nerve palsy.

0:30

These include the inner ear structures

0:31

of the cochlea and the vestibule ,

0:33

leading to hearing loss and potentially disequilibrium.

0:36

And they also include the vascular structures of

0:39

the internal carotid artery and the jugular vein,

0:42

leading to the possibility of either thrombosis or

0:46

aneurysm formation of the arterial structures.

0:49

So let's look at temporal bone fractures.

0:52

There's different classifications

0:54

of temporal bone fractures.

0:55

The classic classification was longitudinal along the

1:00

horizontal portion of the temporal bone versus transverse

1:04

along the vertical portion of the temporal bones.

1:06

And these temporal bone fractures were initially

1:09

classified in this due to the difference

1:11

in the rate of facial nerve injury,

1:13

where there's a much higher rate of facial nerve injury

1:16

with transverse fractures. However, in general,

1:20

we looked at these fractures over the course of time

1:24

and the majority of them ended up being oblique.

1:27

That is,

1:28

not exactly in the horizontal plane or not exactly

1:32

in the vertical plane, but along an oblique plane.

1:35

So pretty much the longitudinal and transverse way

1:38

of looking at things have been thrown out.

1:41

And now, we have a new classification of the

1:44

way we discuss temporal bone fractures,

1:46

and that is otic capsule violating or otic capsule

1:51

sparing. And by the otic capsule,

1:53

we're talking about basically the cochlea,

1:55

vestibule, and semicircular canals.

Case 6 - Temporal Bone Fractures

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