Temporal bone fractures

Question 1

Temporal bone?

Answer 1

The temporal bone contributes to the lower lateral walls of the skull. It contains the middle and inner portions of the ear, and is crossed by the majority of the cranial nerves. The lower portion of the bone articulates with the mandible, forming the temporomandibular joint of the jaw.

Question 2

History?

Answer 2

Injury mechanism 
Hearing loss 
Facial palsy 
Vertigo 
CSF leak 
Associated injuries

Question 3

Examination?

Answer 3

Bruising over mastoid – Battle sign 
Condition of TM and ear canal 
VII 
Immediate facial nerve palsy? 
Hearing test

Question 4

Classification?

Answer 4

Longitudinal or transverse]

Question 5

Longitudinal?

Answer 5

More common
Lateral blows
Conductive deafness
Bleeding line parallels long axis of petrous pyramid

Question 6

Transverse?

Answer 6

Less common
Worse
Frontal blows
Damage to auditory and facial nerves
Sensorineural hearing loss (8th CN damage)
Facial nerve palsy and vertigo