Longitudinal vs transverse petrous temporal bone fracture

Last revised by Dr Yair Glick on 29 Sep 2022

Petrous temporal bone fractures are classically divided into longitudinal, transverse or mixed fracture patterns, depending on the direction of fracture plane with respect to the long axis of the petrous temporal bone. Some features may aid in distinguishing them.

  • more common pattern of temporal bone fracture (70-90%)
  • the fracture line is parallel to the long axis of the petrous temporal bone
  • the otic capsule is spared
  • ossicles are often involved, resulting in conductive hearing loss
  • involvement of the tympanic membrane
  • possible facial nerve involvement (~25%)
  • less common pattern of temporal bone fracture (10-30%)
  • the fracture line is perpendicular to the long axis of the petrous temporal bone
  • the otic capsule is often involved, resulting in sensorineural hearing loss
  • the ossicles and the tympanic membrane are usually spared
  • facial nerve involvement more common (~50%)

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Cases and figures

  • Figure 1: axis of longitudinal fracture
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  • Figure 2: axis of transverse fracture
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