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Temporal bone fracture in Adult
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Temporal bone fracture in Adult

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Contributors: Paul C. Bryson MD
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Synopsis

Head trauma can involve fracture and hemorrhage within the temporal bone and impairment of its contents, which include middle and inner ear (in the petrous portion of the temporal bone), seventh and eighth cranial nerve, the carotid artery, and the internal jugular vein. This condition is most often reported as the result of motor vehicle accidents, falls, or acts of violence. It may be a longitudinal or transverse, oblique or mixed-type injury. Newer classifications more predictive of outcome specify otic capsule violating vs. otic capsule sparing. Frequently, a longitudinal fracture may present with ear injuries, mastoid ecchymosis (Battle's sign) or periorbital ecchymosis (raccoon eyes), tympanic membrane laceration, bleeding in ear canal, and hemotympanum. Horizontal fracture may be associated with facial nerve injury. Other signs and symptoms include facial palsy or numbness, otorrhea (blood or cerebrospinal fluid), hearing loss, nausea, vomiting, nystagmus, and vertigo. Conductive hearing loss may result. Other complications, such as ossicular fixation, air trapped in the inner ear, and temporary or permanent and complete sensorineural hearing loss, may present months after the initial trauma.

Some symptoms may resolve spontaneously. Others may require myringoplasty, tympanoplasty, chain reconstruction of the ossicles, or facial nerve decompression / repair. Leakage of cerebrospinal fluid that fails to heal spontaneously requires treatment, drainage, or surgery to avoid increased threat of infection and meningitis.

Codes

ICD10CM:
S02.19XA – Other fracture of base of skull, initial encounter for closed fracture
S02.19XB – Other fracture of base of skull, initial encounter for open fracture

SNOMEDCT:
83969004 – Fracture of temporal bone

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Last Reviewed: 02/06/2017
Last Updated: 02/06/2017
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Temporal bone fracture in Adult
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Temporal bone fracture : Facial palsy, Hearing loss, Nystagmus, Vertigo
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