Presentation
Fall from 3m into concrete pavement.
Patient Data
Comminuted oblique fracture extending through the left petrous temporal bone. The fracture extends into the middle cranial fossa through the superior semicircular canal with small amount of pneumocephalus. The second component extends into the supracondylar fossa. There also fluid in the external auditory canal and middle ear. There is disruption of the ossicular chain (incudomalleolar joint).
Non-contrast CT brain show hemorrhagic contusions involving rectal gyrus of the left frontal lobe and orbital gyri bilaterally. There is also a shallow subdural hematoma adjacent to the cerebral falx anteriorly and layering on the tentori cerebelli.
Case Discussion
This an example of a mixed petrous temporal bone fracture with fracture lines running both transverse and longitudinal in respect to the long axis of the petrous temporal bone. There is disruption of the ossicular chain (incudomalleolar joint).
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