Mr sunil, 22 year old male was brought in emergency room after scuffle in which he was punched over his face by a drunkard on road side. The patient was conscious and blood was trickling from right ear. The bleeding was controlled at that time. Next day the Audiometry of the patient showed conductive type of hearing loss. The type of temporal bone fracture the patient has?: (A) Longitudinal, (B) Transverse, (C) Oblique, (D) Mixed
Answer is A. Longitudinal Middle cranial Fossa is involved in 60%-80% of fracture of skull base. Types of Temporal bone fracture include Longitudinal, Transverse. Mixed, Oblique and Unusual. Longitudinal : -The longitudinal is one where fracture line runs parallel to the Petrous ridge, that is longitudinal axis of the bone -It constitutes 85% of all the Temporal Bone . 23% are bilateral. -Fracture begins in Squamous Temporal Bone & continues towards the Petrous apex, coursing around the dense Otic capsule bone. -hearing loss is common after the injury; -these invariably results in laceration of the roof of the External Auditory Canal and often the tympanic membrane blood from the middle ear appears in the of External Auditory Canal, leading to a-dictum,that bloody -Vestibular disorders are unusual -Spontaneous Nystagmus is Rare. -Facial N. is usually spared -Most extends along the Fallopian Canal rather than across it. -Facial weakness after this is usually incomplete and is most often delayed, secondary. to the edema rather than disruption of the nerve. Transverse : This runs right angle to the longitudinal axis of the Petrous bone. This pattern represents 15%-30% of Temporal Bone . Caused by: - Blow on the Occipul or less commonly a direct frontal blow. Transverse has a higher moality than longitudinal and greater force is requiredto generate them. The "Classical' Transverse begins in Posterior Cranial Fossa, usually in the region of Foramen Lacerum or Foramen Spinosum. The hearing loss in transverse is usually S nsorineural, caused by disruption of the integrity of the labyn or the neurovascular bundle in the internal auditory canal. Veigo with spontaneous Nystagmus & post traumatic common after, it. Facial N. paresis is also common (50%), it is immediate and r intensity than longitudinal . Mixed : Involves a combination of several of the routes, described. Oblique : Not much is known about this type but a recent study shows that these types of are actually the most common (75%). Other of temporal Bone: of anterior wall of External Auditory Canal can occur in conjugation with injuries to the Mandible.