Skull fractures

Question 1

2 Common fractures of the temporal bone…

Answer 1

Transverse and longitudinal

Question 2

Signs of a temporal bone fracture…

Answer 2

CSF may leak from ear or nose (oto/rhinorrhea)
Hemotympanum, blood behind the TM
Facial pariesis or paralysis due to facial nerve injury

Question 3

Longitudinal fractures are better but may cause…

Answer 3

up to 80%of all temporal bone fractures
Run along the external auditory canal.
Will cause TM external auditory canal laceration.
Haemotympanum
Ossicular chain disruption
up to 20% experience facial nerve injury

Question 4

Transverse fractures are bad and cause…

Answer 4

20% of all temporal bone fractures.
High incidence of otic capsule involvement leading to cochlear and vestibular structures destroyed.
Cause profound SNHL and severe vertigo.
50% suffer facial nerve paralysis.

Question 5

Temporal bone fracture in kids outcomes….

Answer 5

3/4 longitudinal 1/4 transverse.
Rare injury to facial nerve
80% will have HL, 10 mixed 20 SNHL rest conductive.
75% will resolve spontaneously
If conductive 30 at 3 weeks repeat audiogram

Question 6

Middle ear surgery in longitudinal fracture when…

Answer 6

If HL persists for 6 months continue to ossiculoplasty for ossicular chain discontinuity