What are the five portions of the temporal bone?
Squamous portion; tympanic portion, mastoid process, styloid process and petrous process; There is also a zygomatic process which extends anteriorly.
- Complex anterior right frontal, intracranial, extraaxial and intraparenchymal gas containing haematoma. Extraaxial right frontal gas containing haematoma associated with the depressed skull fracture continuous medially with a right frontal pole contusion and the subarachnoid spaces of the interhemispheric fissure and inferior frontal poles. Local mass effect and surrounding oedema and ipsilateral sulcal effacement. Very minor subfalcine herniation (4 mm). Basal cisterns patent. No descending transtentorial herniation. Small focus of subarachnoid haemorrhage in the interpeduncular cistern. Small volume sub dural haematoma layering over the falx.
- Complex comminuted open right anterior calvarial, anterior and central skull base, and facial fractures.
- Right frontal and squamous temporal calvarial skull fracture depressed by 12mm.
- Depressed comminuted frontal air sinus fracture.
- Anterior skull base; laterally compressed frontal bone and lesser sphenoid wing (orbital roof) overlapped fracture extending medially into the ethmoid air cells. Posterior displacement of the superior orbital rim, intra-orbital extraconal gas and relative proptosis.
- Central skull base; Posterior ethmoid / sphenoid sinus fracture involving the medial to the anterior clinoid process in the region of the cavernous ICA anterior genu and the optic canal. Laterally compressed comminuted sphenoid ridge fracture, extending laterally into the lateral orbital wall and inferiorly to involve the pterygopalatine fossa (minimally displaced). No involvement of foramina rotundum, ovale, or spinous.
- Undisplaced longitudinal left petrous temporal bone fracture passing through the medial opacified mastoid air cells, and the anterior external auditory canal wall into the temporomandibular joint. Ossicular chain intact. No involvement of the inner ear or neurovascular canals identified. Associated temporomandibular joint and adjacent parapharyngeal soft tissue gas.