Longitudinal temporal bone fractures

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Longitudinal temporal bone fractures normally occur parallel to the long axis of the petrous bone. A more current classification of the extent of temporal bone fractures describes the integrity of the otic capsule rather than the fracture orientation (see temporal bone fractures.)

Epidemiology

Longitudinal fractures represent the majority (70-90%) of temporal bone fractures. Periauricular swelling and retroauricular ecchymosis (Battle sign) are common, and almost all have otorrhagia.

Pathology

Mechanism

Such a fracture typically originates from squama temporalis with the inferior propagation of the fracture line through the mastoid into the lateral wall of the middle ear, passing behind, through, or in front of the external auditory canal and ends in middle cranial fossa adjacent to the foramen spinosum and foramen lacerum.

Depending on the force of impact, the fracture line may extend, deviated by the strong petrous bone, through the anteromedial wall of the middle ear. Involvement of the otic capsule is rare, but the fracture line can involve the squamous part of the temporal bone and/or the parietal bone.

Complications

tympanic membrane rupture
ossicular injury including incudostapedal dislocation
conductive hearing loss
facial paralysis (~25%) ¹
pneumocephalus
herniation of temporal lobe

-<p><strong>Longitudinal temporal bone fractures</strong> normally occur parallel to the long axis of the <a href="/articles/temporal-bone-1">petrous bone</a>. A more current classification of the extent of temporal bone fractures describes the integrity of the otic capsule rather than the fracture orientation (see <a href="/articles/temporal-bone-fractures">temporal bone fractures</a>.)</p><h4>Epidemiology</h4><p>Longitudinal fractures represent the majority (70-90%) of <a href="/articles/temporal-bone-fractures">temporal bone fractures</a>. Periauricular swelling and retroauricular ecchymosis (Battle sign) are common, and almost all have otorrhagia. </p><h4>Pathology</h4><h5>Mechanism</h5><p>Such a fracture typically originates from squama temporalis with the inferior propagation of the fracture line through the <a href="/articles/temporal-bone-1">mastoid</a> into the lateral wall of the middle ear, passing behind, through, or in front of the <a title="External auditory canal" href="/articles/external-auditory-canal">external auditory canal</a> and ends in <a title="Middle cranial fossa" href="/articles/middle-cranial-fossa">middle cranial fossa</a> adjacent to the <a title="Foramen spinosum" href="/articles/foramen-spinosum">foramen spinosum</a> and <a title="Foramen lacerum" href="/articles/foramen-lacerum">foramen lacerum</a>. </p><p>Depending on the force of impact, the fracture line may extend, deviated by the strong <a href="/articles/temporal-bone-1">petrous bone</a>, through the anteromedial wall of the <a title="Middle ear" href="/articles/middle-ear">middle ear</a>. Involvement of the <a href="/articles/otic-capsule">otic capsule</a> is rare, but the fracture line can involve the <a href="/articles/squamous-part-of-temporal-bone">squamous part of the temporal bone</a> and/or the <a href="/articles/parietal-bone">parietal bone</a>. </p><h5>Complications</h5><ul>
+<p><strong>Longitudinal temporal bone fractures</strong> normally occur parallel to the long axis of the <a href="/articles/temporal-bone-1">petrous bone</a>. A more current classification of the extent of temporal bone fractures describes the integrity of the otic capsule rather than the fracture orientation (see <a href="/articles/temporal-bone-fractures">temporal bone fractures</a>.)</p><h4>Epidemiology</h4><p>Longitudinal fractures represent the majority (70-90%) of <a href="/articles/temporal-bone-fractures">temporal bone fractures</a>. Periauricular swelling and retroauricular ecchymosis (Battle sign) are common, and almost all have otorrhagia. </p><h4>Pathology</h4><h5>Mechanism</h5><p>Such a fracture typically originates from squama temporalis with the inferior propagation of the fracture line through the <a href="/articles/temporal-bone-1">mastoid</a> into the lateral wall of the middle ear, passing behind, through, or in front of the <a href="/articles/external-auditory-canal">external auditory canal</a> and ends in <a href="/articles/middle-cranial-fossa">middle cranial fossa</a> adjacent to the <a href="/articles/foramen-spinosum">foramen spinosum</a> and <a href="/articles/foramen-lacerum">foramen lacerum</a>. </p><p>Depending on the force of impact, the fracture line may extend, deviated by the strong <a href="/articles/temporal-bone-1">petrous bone</a>, through the anteromedial wall of the <a href="/articles/middle-ear">middle ear</a>. Involvement of the <a href="/articles/otic-capsule">otic capsule</a> is rare, but the fracture line can involve the <a href="/articles/squamous-part-of-temporal-bone">squamous part of the temporal bone</a> and/or the <a href="/articles/parietal-bone">parietal bone</a>. </p><h5>Complications</h5><ul>
~~-<a title="Tympanic membrane" href="/articles/tympanic-membrane">tympanic membrane</a> rupture</li>~~
+<a href="/articles/tympanic-membrane">tympanic membrane</a> rupture</li>
~~-<li>herniation of <a title="Temporal lobe" href="/articles/temporal-lobe">temporal lobe</a>~~
+<li>herniation of <a href="/articles/temporal-lobe">temporal lobe</a>

References changed:

5. Yeakley JW. Temporal bone fractures. Current problems in diagnostic radiology. 28 (3): 65-98. <a href="https://www.ncbi.nlm.nih.gov/pubmed/10327292">Pubmed</a> <span class="ref_v4"></span>
6. Patel A, Groppo E. Management of temporal bone trauma. Craniomaxillofacial trauma & reconstruction. 3 (2): 105-13. <a href="https://doi.org/10.1055/s-0030-1254383">doi:10.1055/s-0030-1254383</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22110824">Pubmed</a> <span class="ref_v4"></span>
7. C.P. Wood, C.H. Hunt, D.C. Bergen, M.L. Carlson, F.E. Diehn, K.M. Schwartz, G.A. McKenzie, R.F. Morreale, J.I. Lane. Tympanic Plate Fractures in Temporal Bone Trauma: Prevalence and Associated Injuries. American Journal of Neuroradiology. 35 (1): 186. <a href="https://doi.org/10.3174/ajnr.A3609">doi:10.3174/ajnr.A3609</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23828114">Pubmed</a> <span class="ref_v4"></span>

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