Men are more affected than women. Associated trauma to other cranial nerves (other than the facial nerve; ie, VI [abducens], IX [glossopharyngeal], X [vagus], and XI [spinal accessory]) can also cause paralysis. Based on these findings, which of the following is the most likely diagnosis? Delayed-onset or incomplete facial paralysis almost always resolves with conservative management, including use of corticosteroids, which are gradually tapered. [Medline]. Otolaryngol Head Neck Surg. The Battle sign (ecchymosis of the postauricular skin) and the raccoon sign (ecchymosis of the periorbital area) may be noted in either type of fracture. [Medline]. The image below depicts right temporal bone transverse fracture with severe spontaneous nystagmus. Recently, temporal bone fractures related to motor vehicle accidents appear to have decrease, temporal bone fractures related to assaults, particularly in large urban populations, appear to have increased. Nonoperative management of traumatic facial nerve palsy. Usually, the otolaryngology-head and neck surgeon is called in for consultation when the patient is fully stable, many hours after the traumatic event. 2015 Jul. Temporal bone injuries reportedly occur in 14-22% of all skull fractures. Trauma patterns, symptoms, and complications associated with external auditory canal fractures. [18, 19, 20] . Ishman SL, Friedland DR. Temporal bone fractures: traditional classification and clinical relevance. Laryngoscope. Internal aspect of the skull base depicting, in green color, a mixed temporal bone fracture line with both a longitudinal pattern (circle) and a transverse pattern (rectangle). Airway management, evaluation of neurological status, hemorrhage, open fractures, and abdominal and chest injuries may delay early diagnosis and treatment of temporal bone injuries. Some fractures may have characteristics of both patterns. 1974 Dec. 84(12):2141-54. Diseases & Conditions, 2002
2001. External auditory canal fractures are seen in all age groups. Holland BA, Brant-zawadzki M. High-resolution CT of temporal bone trauma. Ped Inf Dis J. 2015 May-Jun. Stab and gunshot wounds are the most common penetrating wounds. They are usually caused by a frontal or parietal blow but may result from an occipital blow. 38 (4):572-6. They are frequently caused by a lateral force over the mastoid or temporal squama, usually produced by temporal or parietal blows. Laryngoscope. Am J Otol. Arch Otolaryngol Head Neck Surg. Maiman DJ, Cusick JF, Anderson AJ, Larson SJ. Otolaryngol Head Neck Surg. Associated injuries of cranial nerves (other than the seventh) can occur, as well as intracerebral damage and arterial or venous injury. Please confirm that you are a health care professional. Longitudinal fractures comprise 80% of all temporal bone fractures. Other causes, in descending order of frequency, are physical assaults, falls, motorcycle accidents, pedestrian injuries, bicycle accidents, and gunshot wounds. Choi HG, Lee HJ, Lee JS, et al. With the occurrence of perilymphatic fistulas, medical treatment initially consists of bed rest, head elevation, and stool softeners. 23(6):377-80. Case 2: longitudinal temporal bone fracture, Case 4: longitudinal temporal bone fracture, Case 5: transverse temporal bone fracture, Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, fluid opacification within the temporal bone.