In the modern world, the most common cause of head trauma causing temporal bone fracture in adults is road traffic accidents with high impact force. Hearing loss is one of the most common complaints after head trauma involving temporal bone fracture. Because of other life-threatening conditions associated with road traffic accidents, fractures of temporal bone is often overlooked. If these fractures are detected early, there complications can be avoided with conservative or surgical intervention. In this research following databases were used to search for published as well as unpublished studies over the period 2000–2021 in the English language: PubMed, EMBASE, and Web of Science. The terms used to generate a search were as follows: Temporal bone fracture and hearing loss. Those studies which did not fulfil the inclusion criteria were removed. Case reports, documentaries, and duplicate data were excluded. Most common cause of injury leading to temporal bone fracture was road traffic accident. Majority of cases were males belonging to the age group of 31–40 years and average age was 36 years. According to traditional classification, majority had longitudinal fracture followed by transverse fracture. According to newer classification, otic capsule sparing was more common in comparison to otic capsule involvement. The conductive type of hearing loss was more common and it was found associated with longitudinal fracture while sensorineural type of hearing loss was associated with transverse type of fracture. The conductive type of hearing loss was usually common in otic capsule sparing while sensorineural type of hearing loss is associated with otic capsule involvement. Otic capsule sparing is mostly seen in longitudinal fracture and transverse fracture involves otic capsule involvement. Head trauma due to fast moving vehicles is the most common cause of injury leading to temporal bone fracture. Because of complex structure of temporal bone identification of line of fracture is necessary which requires high-resolution computed tomography (CT) of the head. High-resolution CT not only helps in knowing anatomy and types of fracture but also it helps in knowing sequelae of various types of fractures which helps in treating physician weather to go for conservative or surgical intervention.

Head injury caused by high force can lead to severe complications if fracture of the temporal bone is present. It is rare that temporal bone fracture causes pneumolabyrinth; there is an entry of air into the vestibulocochlear system due to the fracture line communicating inner ear to the middle ear. Vestibular pneumolabyrinth is more common than cochlear pneumolabyrinth. For initial evaluation of polytrauma patients with fracture of the temporal bone, multidetector computed tomography (CT) with high resolution and multiplanar reformation play an important role in the identification of important structures lying in close relation to the temporal bone that may lead to severe complications if fracture line is traversing through them. We herein present an interesting case of a 39-year-old man who underwent a road traffic accident leading to transverse temporal bone fracture and cerebral contusion. After discharge from the hospital, the patient complained of decreased hearing in the ipsilateral ear and difficulty in maintaining balance. On CT, otic capsule violating fracture was noted with pneumolabyrinth. First, the patient was treated conservatively, following no improvement in his condition, he was surgically treated and gained full recovery. Early detection of otic capsule involvement in cases of temporal bone fracture can provide effective treatment which will further lead to decrease in complications which if left untreated could have resulted in drastic consequences contributing to irrecoverable hearing loss. One should always pay attention while reporting for CT scans and always look for the location of air bubbles in the otic capsule as the line of fracture is not visualized properly in the presence of mastoid collection.