Clinical View of the Otorhinolaryngologist and Radiologist on the Classification of Fractures of the Temporal Bone
Abstract
Temporal bone fractures are traditionally classified as transverse, longitudinal or mixed (according to the direction of fracture). However, this classification has shown little association with clinical symptoms and later progressive symptomatology, and therefore a new classification system has been introduced based on High-Resolution Computed Tomography.
It includes the involvement of all parts of the temporal bone (processus mastoideus, pars squamosa, pars tympanica, pars petrosa) and involvement or sparing of the otic capsule (vestibule, cochlea, semicircular canals). The authors carried out a retrospective analysis of 89 patients with a fracture of the temporal bone using high-resolution computed tomography scans taken in the period from January 2003 to September 2013.
They compared the correlation between the new classification of fractures of the temporal bone and the clinical symptoms. Involvement of the petrous bone was associated with a higher incidence of sensorineural hearing loss, especially in patients with fractures affecting the otic capsule.
In these cases, we found severe hearing impairments or deafness. The patients with petrous fracture affecting the otic capsule showed a higher incidence of facial palsy.
The occurrence of dizziness, tinnitus and perforation of tympanic membrane was higher in petrous fractures, especially when the otic capsule was involved. There were no significant differences between non-petrous and petrous fractures in terms of the occurrence of otorrhoea and hemotympanum.
The new classification of fractures according to the involvement of individual parts of the temporal bone has a better correlation with clinical symptoms.