- Temporal bone fracture
- Often with fractures of calvaria and brain injury
- Thin-slice CT
- Complications
- CSF leak
- Air in intracranial cavity
- CSF otorrhoea
- CSF rhinorrhoea
- Meningitis
- Brain abscess
- Surgery only if it persists
- Cochleovestibular symptoms
- Conductive (fluid in middle ear)
- Sensorineural (fracture of labyrinth)
- Facial nerve symptoms
- Types
- Longitudinal fractures
- Fracture runs along the external auditory canal and the anterior border of the petrous pyramid
- Most common
- Lateral trauma
- Clinical features
- Ear discharge with blood and/or CSF
- Hearing loss
- Delayed facial paralysis
- Tearing of meatal skin and TM
- Complications
- Fracture of auditory ossicles
- Meningitis
- Otitis media
- Treatment
- Conservative
- Surgery if complications
- Transverse fractures
- Fracture runs across the petrous pyramid along the internal auditory canal and/or through the labyrinth
- Vestibule, cochlea destroyed
- Frontal trauma
- Much less common
- Clinical features
- Vestibular symptoms
- Hearing loss
- Immediate facial paralysis
- No otorrhoea
- Haemotympanum
- Complications
- Higher risk of meningitis
- Hearing and vestibular function never recovers
- Treatment
- Conservative
- Surgery if CSF leak