Temporal bone fracture

From greek.doctor
  • 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)
          • Vertigo
          • Nausea
      • 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