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Temporal Bone Fractures

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Let's talk a little bit more about temporal

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bone fractures in general.

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So you might ask what's the big importance

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of temporal bone fractures? Well,

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the importance of temporal bone fractures is that there are

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a lot of small structures that course through the temporal

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bones that may be injured at the time of trauma.

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These include the small ossicles of the malleus,

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the incus and the stapes.

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This includes the facial nerve and leading

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to potential facial nerve palsy.

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These include the inner ear structures

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of the cochlea and the vestibule ,

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leading to hearing loss and potentially disequilibrium.

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And they also include the vascular structures of

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the internal carotid artery and the jugular vein,

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leading to the possibility of either thrombosis or

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aneurysm formation of the arterial structures.

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So let's look at temporal bone fractures.

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There's different classifications

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of temporal bone fractures.

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The classic classification was longitudinal along the

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horizontal portion of the temporal bone versus transverse

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along the vertical portion of the temporal bones.

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And these temporal bone fractures were initially

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classified in this due to the difference

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in the rate of facial nerve injury,

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

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with transverse fractures. However, in general,

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we looked at these fractures over the course of time

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and the majority of them ended up being oblique.

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That is,

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not exactly in the horizontal plane or not exactly

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in the vertical plane, but along an oblique plane.

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So pretty much the longitudinal and transverse way

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of looking at things have been thrown out.

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And now, we have a new classification of the

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way we discuss temporal bone fractures,

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and that is otic capsule violating or otic capsule

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sparing. And by the otic capsule,

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we're talking about basically the cochlea,

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vestibule, and semicircular canals.

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Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Trauma

Temporal bone

Skull Base

Neuroradiology

Head and Neck

Emergency

CT

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