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FRACTURES OF THE PETROUS AND TYMPANIC PARTS OF THE TEMPORAL BONE IN CHILDREN: A TOMOGRAPHIC STUDY OF 35 CASES

DEREK C. HARWOOD-NASH M.B., CH.B., F.R.C.P.(C)1

1 Neuroradiologist, the Hospital for Sick Children, Toronto, Ontario, Canada.

The fractures of the petrous bone in children are: longitudinal, transverse, or combined, relative to the axis of the bone. Hypocycloida1 tomography demonstrated that, in addition to these accepted patterns, longitudinal fractures can involve the anterior and the posterior portions of the petrous bone; an associated fracture of the tympanic part of the temporal bone occurs in two-thirds of all petrous fractures; and combined fractures result in distractive fragmentation of petrous bone. An associated ossicular disruption is uncommon.

Standard roentgenographic studies of the temporal bone are inadequate to demonstrate these complex fractures. Aggressive tomographic studies of the petrous bone are indicated if one or more of a triad of presenting signs of C.S.F. otorrhea, low motor neuron seventh nerve palsy, or severe bleeding from the middle ear are present.


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