Longitudinal temporal bone fractures
Citation, DOI, disclosures and article data
At the time the article was created Bruno Di Muzio had no recorded disclosures.View Bruno Di Muzio's current disclosures
At the time the article was last revised Daniel J Bell had no recorded disclosures.View Daniel J Bell's current disclosures
Longitudinal temporal bone fractures are petrous temporal bone fractures that occur parallel to the long axis of the petrous temporal bone. Although more current classifications of the extent of temporal bone fractures focus on the integrity of the otic capsule rather than the fracture orientation, description of fractures in terms of longitudinal or transverse or mixed orientation is still common and useful in conveying the fracture anatomy.
Longitudinal fractures represent the majority (70-90%) of all petrous temporal bone fractures. Periauricular swelling and retroauricular ecchymosis (Battle sign) are common, and almost all have otorrhagia.
Longitudinal temporal bone fractures typically originate from the squamous temporal bone with the inferior propagation of the fracture line through the mastoid into the lateral wall of the middle ear, passing behind, through, or in front of the external auditory canal and ends in middle cranial fossa adjacent to the foramen spinosum and foramen lacerum.
Depending on the force of impact, the fracture line may extend, deviated by the strong petrous bone, through the anteromedial wall of the middle ear. Involvement of the otic capsule is rare, but the fracture line can involve the squamous part of the temporal bone and/or the parietal bone.
- tympanic membrane rupture
- ossicular injury including incudostapedial joint dislocation
- conductive hearing loss
- facial paralysis (~25%) 1
- herniation of temporal lobe through fracture
- perilymphatic fistula
- 1. Ishman SL, Friedland DR. Temporal bone fractures: traditional classification and clinical relevance. Laryngoscope. 2004;114 (10): 1734-41. doi:10.1097/00005537-200410000-00011 - Pubmed citation
- 2. Johnson F, Semaan MT, Megerian CA. Temporal bone fracture: evaluation and management in the modern era. Otolaryngol. Clin. North Am. 2008;41 (3): 597-618, x. doi:10.1016/j.otc.2008.01.006 - Pubmed citation
- 3. Holland BA, Brant-zawadzki M. High-resolution CT of temporal bone trauma. AJR Am J Roentgenol. 1984;143 (2): 391-5. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Zayas JO, Feliciano YZ, Hadley CR, Gomez AA, Vidal JA. Temporal bone trauma and the role of multidetector CT in the emergency department. Radiographics : a review publication of the Radiological Society of North America, Inc. 31 (6): 1741-55. doi:10.1148/rg.316115506 - Pubmed
- 5. Yeakley JW. Temporal bone fractures. Current problems in diagnostic radiology. 28 (3): 65-98. Pubmed
- 6. Patel A, Groppo E. Management of temporal bone trauma. Craniomaxillofacial trauma & reconstruction. 3 (2): 105-13. doi:10.1055/s-0030-1254383 - Pubmed
- 7. C.P. Wood, C.H. Hunt, D.C. Bergen, M.L. Carlson, F.E. Diehn, K.M. Schwartz, G.A. McKenzie, R.F. Morreale, J.I. Lane. Tympanic Plate Fractures in Temporal Bone Trauma: Prevalence and Associated Injuries. American Journal of Neuroradiology. 35 (1): 186. doi:10.3174/ajnr.A3609 - Pubmed