Presentation
Trauma.
Patient Data
A 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 the fracture through the vestibular aqueduct and the superior semicircular canal. The fracture extends through the stapes footplate at the oval window and displaced fractures of the stapedial crura and dislocation of the incudostapedial joint. There is a hemotympanum and almost certainly a perilymphatic fistula from the stapedial footplate fracture.
The fracture traverses the anterior genu and the anterior aspect of the tympanic segment of the facial nerve bony canal.
A fracture of the clivus is noted. Opacification of pneumatized 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.
Unable to process the form. Check for errors and try again.