Patterns and incidence of temporal bone fractures

Authors : Sandeep Velicheti, Rani Tadicherla, Tadicherla Movva, Chandrasekhar Kondragunta, Deepthi G

DOI : 10.18231/j.ijmi.2019.023

Volume : 5

Issue : 4

Year : 2019

Page No : 84-88

Introduction: Temporal bone has a complex anatomy, divided into five bony divisions, which include squamous part, petrous bone, tympanic part, mastoid process, and styloid process. This contains cranial nerves V, VI, VII, and VIII and vascular structures such as the internal carotid and middle meningeal arteries, the sigmoid sinus, and the jugular bulb. It also harbors the sensorineural and membranous structures of the inner ear.
The most common cause of temporal bone fractures is high energy blunt head trauma. For the assessment of temporal fractures, cranial CT is a fundamental and initial diagnostic modality.
Complications of temporal bone fractures include facial nerve palsy, cerebrospinal fluid leakage, conductive hearing loss, sensorineural hearing loss, and vertigo. These fractures are divided into longitudinal and transverse based on whether the fracture line is passing parallel to or perpendicular to petrous bone respectively.
Materials and Methods: This was a cross-sectional study done at Dr. PSIMS & RF, Gannavaram, Andhra Pradesh. The study period was between January 2015 to December 2018, done on Siemens 16 Slice CT machine with the patients' age ranging from 18 to 70 years who underwent CT brain in view of Road traffic accidents.
Results: Among the total number of 30 patients, we have divided into combined fractures of various parts and isolated fractures of various parts. Isolated petrous fracture seen in 3 cases, squamous in 10 and mastoid in 5 patients, among the fractures, isolated squamous (58.8%) is the most common one seen. In thirteen cases (43.3%) combined fractures of at least two parts seen, among the various combinations seen the most common one is squamous – mastoid 7(50%). Among the total number of cases, facial nerve canal is involved in 7(23%) cases, out of which clinically 4(57.1%) cases presented with facial palsy. Carotid canal is involved in 3(10%) cases, pneumocephalus secondary to mastoid fracture in 6(20%) cases. Hemomastoideum is a common accompaniment in temporal bone fractures almost seen in 18(60%) cases, hemotympanum is seen in 14 cases. In one case, there is bilateral temporal bone fractures with severe injuries. Cochlear & semicircular canal involvement is seen in one among the total number of patients. Among the 30 cases, petrous temporal bone fracture seen in 10 cases, out of which longitudinal fractures seen in 8 cases (10%), mixed fracture is seen in 1 case and transverse fracture in 1 case.

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