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Temporal bone fractures

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Abstract

Temporal bone injury is frequently associated with severe brain injury which limits the clinical evaluation and detracts from the clinical signs of temporal bone fracture such as sensorineural hearing loss, conductive hearing loss, and facial nerve paralysis. Radiologists are often the first to note the presence of temporal bone fractures and should be familiar with common types of injuries and their clinical implications. We review the traditional classification systems of temporal bone fractures with respect to clinical findings and management and suggest that radiologists should be familiar with the classification systems and, more importantly, focus their attention to identifying all critical temporal bone structures and describing their status of involvement to better the individual care.

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References

  1. McKennan KX, Chole RA (1992) Facial paralysis in temporal bone trauma. Am J Otol 13(2):167–172

    PubMed  CAS  Google Scholar 

  2. Brodie HA, Thompson TC (1997) Management of complications from 820 temporal bone fractures. Am J Otol 18(2):188–197

    PubMed  CAS  Google Scholar 

  3. Jennett B et al (1980) Treatment for severe head injury. J Neurol Neurosurg Psychiatry 43(4):289–295

    Article  PubMed  CAS  Google Scholar 

  4. Virapongse CSB a.M.S. ed. (1987) Radiology of the abnormal ear. Radiology: diagnosis-imaging-intervention, ed. J.a.F.J. Taveras. Vol. III. Lippincott: Philadelphia

  5. Harker L, McCabe BF (1991) Temporal bone fracture and facial nerve injury. Otolaryngol Clin North Am 1991(24):425–431

    Google Scholar 

  6. Kerman M, Cirak B, Dagtekin A (2002) Management of skull base fractures. Neurosurg Q 12(1):23–41 doi:10.1097/00013414-200203000-00003

    Article  Google Scholar 

  7. Darrouzet V et al (2001) Management of facial paralysis resulting from temporal bone fractures: our experience in 115 cases. Otolaryngol Head Neck Surg 125(1):77–84 doi:10.1067/mhn.2001.116182

    Article  PubMed  CAS  Google Scholar 

  8. Ishman SL, Friedland DR (2004) Temporal bone fractures: traditional classification and clinical relevance. Laryngoscope 114(10):1734–1741 doi:10.1097/00005537-200410000-00011

    Article  PubMed  Google Scholar 

  9. Travis LW, Stalnaker RL, Melvin JW (1977) Impact trauma of the human temporal bone. J Trauma 17(10):761–766 doi:10.1097/00005373-197710000-00003

    Article  PubMed  CAS  Google Scholar 

  10. Ghorayeb BY et al (1987) Unusual complications of temporal bone fractures. Arch Otolaryngol Head Neck Surg 113(7):749–753

    PubMed  CAS  Google Scholar 

  11. Dahiya R et al (1999) Temporal bone fractures: otic capsule sparing versus otic capsule violating clinical and radiographic considerations. J Trauma 47(6):1079–1083 doi:10.1097/00005373-199912000-00014

    Article  PubMed  CAS  Google Scholar 

  12. Betz BW, Wiener MD (1991) Air in the temporomandibular joint fossa: CT sign of temporal bone fracture. Radiology 180(2):463–466

    PubMed  CAS  Google Scholar 

  13. Holland BA, Brant-Zawadzki M (1984) High-resolution CT of temporal bone trauma. AJR Am J Roentgenol 143(2):391–395

    PubMed  CAS  Google Scholar 

  14. Jones RM et al (2000) Temporal lobe injury in temporal bone fractures. Arch Otolaryngol Head Neck Surg 126(2):131–135

    PubMed  CAS  Google Scholar 

  15. Zimmerman RA et al (1987) Magnetic resonance imaging in temporal bone fracture. Neuroradiology 29(3):246–251 doi:10.1007/BF00451761

    Article  PubMed  CAS  Google Scholar 

  16. Little SC, Kesser BW (2006) Radiographic classification of temporal bone fractures: clinical predictability using a new system. Arch Otolaryngol Head Neck Surg 132(12):1300–1304 doi:10.1001/archotol.132.12.1300

    Article  PubMed  Google Scholar 

  17. Meriot P et al (1997) CT appearances of ossicular injuries. Radiographics 17(6):1445–1454

    PubMed  CAS  Google Scholar 

  18. Yeakley JW (1999) Temporal bone fractures. Curr Probl Diagn Radiol 28(3):65–98 doi:10.1016/S0363-0188(99)90002-6

    Article  PubMed  CAS  Google Scholar 

  19. Bellucci RJ (1983) Traumatic injuries of the middle ear. Otolaryngol Clin North Am 16(3):633–650

    PubMed  CAS  Google Scholar 

  20. Swartz JD et al (1986) Computed tomography of the disarticulated incus. Laryngoscope 96(11):1207–1210

    PubMed  CAS  Google Scholar 

  21. Lourenco MT, Yeakley JW, Ghorayeb BY (1995) The “Y” sign of lateral dislocation of the incus. Am J Otol 16(3):387–392

    PubMed  CAS  Google Scholar 

  22. Hasso AN, Ledington JA (1988) Traumatic injuries of the temporal bone. Otolaryngol Clin North Am 21(2):295–316

    PubMed  CAS  Google Scholar 

  23. Singh S, Salib RJ, Oates J (2002) Traumatic fracture of the stapes suprastructure following minor head injury. J Laryngol Otol 116(6):457–459 doi:10.1258/0022215021911068

    Article  PubMed  Google Scholar 

  24. Kim SH, Kazahaya K, Handler SD (2001) Traumatic perilymphatic fistulas in children: etiology, diagnosis and management. Int J Pediatr Otorhinolaryngol 60(2):147–153 doi:10.1016/S0165-5876(01)00485-2

    Article  PubMed  CAS  Google Scholar 

  25. Seltzer S, McCabe BF (1986) Perilymph fistula: the Iowa experience. Laryngoscope 96(1):37–49 doi:10.1288/00005537-198601000-00007

    Article  PubMed  CAS  Google Scholar 

  26. McCabe BF (1989) Perilymph fistula: the Iowa experience to date. Am J Otol 10(4):262

    PubMed  CAS  Google Scholar 

  27. Stallmeyer MJ, Morales RE, Flanders AE (2006) Imaging of traumatic neurovascular injury. Radiol Clin North Am 44(1):13–39 vii. doi:10.1016/j.rcl.2005.08.003

    Article  PubMed  CAS  Google Scholar 

  28. Kerwin AJ et al (2001) Liberalized screening for blunt carotid and vertebral artery injuries is justified. J Trauma 51(2):308–314 doi:10.1097/00005373-200108000-00013

    Article  PubMed  CAS  Google Scholar 

  29. Davis JW et al (1990) Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma 30(12):1514–1517

    Article  PubMed  CAS  Google Scholar 

  30. Biffl WL et al (1998) The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurologic outcome. Ann Surg 228(4):462–470 doi:10.1097/00000658-199810000-00003

    Article  PubMed  CAS  Google Scholar 

  31. Miller PR et al (2002) Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg 236(3):386–393 discussion 393–5. doi:10.1097/00000658-200209000-00015

    Article  PubMed  Google Scholar 

  32. Biffl WL et al (2000) The devastating potential of blunt vertebral arterial injuries. Ann Surg 231(5):672–681 doi:10.1097/00000658-200005000-00007

    Article  PubMed  CAS  Google Scholar 

  33. Biffl WL et al (2002) Noninvasive diagnosis of blunt cerebrovascular injuries: a preliminary report. J Trauma 53(5):850–856 doi:10.1097/00005373-200211000-00008

    Article  PubMed  Google Scholar 

  34. Cothren CC et al (2005) Screening for blunt cerebrovascular injuries is cost-effective. Am J Surg 190(6):845–849

    PubMed  Google Scholar 

  35. Sliker CW, Mirvis SE (2007) Imaging of blunt cerebrovascular injuries. Eur J Radiol 64(1):3–14 doi:10.1016/j.ejrad.2007.02.015

    Article  PubMed  Google Scholar 

  36. Gaskill-Shipley MF, Tomsick TA (1996) Angiography in the evaluation of head and neck trauma. Neuroimaging Clin N Am 6(3):607–624

    PubMed  CAS  Google Scholar 

  37. Taha JM et al (1993) Sigmoid sinus thrombosis after closed head injury in children. Neurosurgery 32(4):541–545 discussion 545–6. doi:10.1097/00006123-199304000-00008

    Article  PubMed  CAS  Google Scholar 

  38. Abuabara A (2007) Cerebrospinal fluid rhinorrhoea: diagnosis and management. Med Oral Patol Oral Cir Bucal 12(5):E397–E400

    PubMed  Google Scholar 

  39. Shetty PG et al (1997) Cerebrospinal fluid otorhinorrhea in patients with defects through the lamina cribrosa of the internal auditory canal. AJNR Am J Neuroradiol 18(3):478–481

    PubMed  CAS  Google Scholar 

  40. Stone JA et al (1999) Evaluation of CSF leaks: high-resolution CT compared with contrast-enhanced CT and radionuclide cisternography. AJNR Am J Neuroradiol 20(4):706–712

    PubMed  CAS  Google Scholar 

  41. Shetty P et al (1998) Evaluation of high-resolution CT and MR cisternography in the diagnosis of cerebrospinal fluid fistula. AJNR Am J Neuroradiol 19(4):633–639

    PubMed  CAS  Google Scholar 

  42. El Gammal T et al (1998) Cerebrospinal fluid fistula: detection with MR cisternography. AJNR Am J Neuroradiol 19(4):627–631

    PubMed  Google Scholar 

  43. Brodie HA (1997) Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae. A meta-analysis. Arch Otolaryngol Head Neck Surg 123(7):749–752

    PubMed  CAS  Google Scholar 

  44. Lambert PR, Brackmann DE (1984) Facial paralysis in longitudinal temporal bone fractures: a review of 26 cases. Laryngoscope 94(8):1022–1026 doi:10.1288/00005537–198408000–00005

    Article  PubMed  CAS  Google Scholar 

  45. Coker NJ et al (1987) Traumatic intratemporal facial nerve injury: management rationale for preservation of function. Otolaryngol Head Neck Surg 97(3):262–269

    PubMed  CAS  Google Scholar 

  46. Fisch U (1974) Facial paralysis in fractures of the petrous bone. Laryngoscope 84(12):2141–2154 doi:10.1288/00005537-197412000-00005

    Article  PubMed  CAS  Google Scholar 

  47. Sartoretti-Schefer S et al (1997) Contrast-enhanced MR of the facial nerve in patients with posttraumatic peripheral facial nerve palsy. AJNR Am J Neuroradiol 18(6):1115–1125

    PubMed  CAS  Google Scholar 

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Correspondence to Nafi Aygun.

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Saraiya, P.V., Aygun, N. Temporal bone fractures. Emerg Radiol 16, 255–265 (2009). https://doi.org/10.1007/s10140-008-0777-3

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  • DOI: https://doi.org/10.1007/s10140-008-0777-3

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