Transverse temporal bone fracture

Case contributed by Prof Oliver Hennessy

Presentation

Trauma.

Patient Data

Age: 68
Gender: Male
Modality: CT

Transverse fracture of the left petrous temporal bone is present. It passes through the anterior and posterior walls of the jugular foramen and carotid canal with mild displacement. There is extensive involvement of the bony labyrinth with extension of fracture through the vestibular aqueduct and the superior semicircular canal. The fracture extends through the staples footplate at the oval window and displaced fractures of the stapedial crura and dislocation of the incudostapedial joint. There is haemotympanum and almost certainly a perilymphatic fistula from the stapedial footplate fracture.

There fracture traverses the anterior genu and the anterior aspect of the tympanic segment of the facial nerve bony canal.

Fracture of the clivus is noted. Opacification of pneumatised mastoid air-cells..

CONCLUSION:

There is acute transverse fracture of the left petrous temporal bone with fracture dislocation of the ossicles and oval window niche resulting in perilymphatic fistula and pneumolabyrinth. The fracture also traverses the anterior genu and tympanic segment of the facial nerve bony canal and involves the jugular foramen and the carotid canal.

Case Discussion

Transverse fractures of the petrous temporal bone are less common than longitudinal fractures. However, they are usually associated with more serious complications.

This case demonstrates involvement of important vascular canal foramina, the facial nerve, and the otic capsule.

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Case Information

rID: 33483
Case created: 14th Jan 2015
Last edited: 8th Sep 2015
System: Head & Neck
Inclusion in quiz mode: Included

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