Traumatic Injury of the Petrous Part of the Temporal Bone: Keys for Reporting a Complex Diagnosis

Abstract

Fractures of the petrous part of the temporal bone are a common lesion of the base of the skull; most of these fractures result from high-energy trauma. In patients with multiple trauma, these injuries can be detected on CT scans of the head and neck, where the direct and indirect signs are usually sufficient to establish the diagnosis. It is important to these fractures because the temporal bone has critical structures and the complexity of this region increases the risk of error unless special care is taken. This article reviews the key anatomical points, the systematization of the imaging findings, and the classifications used for temporal bone fracture. We emphasize the usefulness of identifying and describing the findings in relation to important structures in this region, of looking for unseen fractures suspected through indirect signs, and of identifying anatomical structures that can simulate fractures. We point out that the classical classifications of these fractures are less useful, although they continue to be used for treatment decisions.

Keywords: Basilar skull fracture; Carotid artery trauma; Diagnostic imaging; Diagnóstico por imagen; Ear ossicles, injuries; Emergency department; Facial nerve trauma; Fractura craneal basilar; Hearing loss; Hueso temporal/lesiones; Inner ear, injuries; Osículos del oído/lesiones; Oído interno/lesiones; Pérdida auditiva; Servicios médicos de urgencia; Temporal bone, injuries; Traumatismos de las arterias carótidas; Traumatismos del nervio facial.