Temporal Bone Fractures: Traditional Classification and Clinical Relevance

Abstract

Traditional temporal bone fracture descriptions correlate poorly with clinical findings. However, simply distinguishing petrous from nonpetrous involvement demonstrates significant correlation with the occurrence of serious sequelae of temporal bone fractures. Subcategories of mastoid and middle ear involvement further refine this classification schema to correlate with minor complications. This simple, radiographically based scheme better focuses clinical resources and attention toward more likely sequelae.

Clinical Feasibility of Multiplanar Reconstruction Images of Temporal Bone CT in the Diagnosis of Temporal Bone Fracture with Otic-Capsule-Sparing Facial Nerve Paralysis

“…Thus, if the fracture line reaches those organs, it may induce sensorineural hearing loss [4], CSF otorrhea, or facial nerve paralysis [5,6]. According to a classification based on petrous bone involvement, Ishman reported that petrous bone fractures result in ten times greater likelihood of CSF leak and three times greater likelihood of facial nerve injury compared with non-petrous bone involvement [2]. Thus, it is important to identify where the fracture line ends, particularly when it is directed toward the critical organs.…”

“…Prognostic factors of traumatic facial palsy are the severity and onset time of facial nerve paralysis. Incomplete and delayed types of facial nerve paralysis present a better prognosis [2,9]. Fig.…”

“…New classifications have been suggested that focus on the clinical features of the patients. The latest two classifications of temporal bone fracture were designed by considering insults to the otic capsule [1] and petrous bone [2]. Both of these approaches focused on whether the end of the fracture line reached the critical organs.…”

Temporal Bone Trauma: To Pull Down the Wall of Incommunicableness

“…To enhance treatment quality, TBTs radiographic features should be depicted according to the involvement of all temporal bone components and its potential clinical implications, as recently stressed in the literature [4,5].…”

“…One among most compelling system considers whether the otic capsule structures have been violated or spared. Otic capsule violating fractures have been reported to have a higher incidence of loco-regional complications [4,8].…”