Head and Neck Imaging

Transverse fracture, temporal bone

fracture orientated perpendicular to the long axis of the petrous bone. These fractures often result from an occipital impact. They commonly involve the labyrinth, causing vertigo and sensorineural deafness; such a fracture may cause a perilymphatic fistula. Transverse fractures may also pass medial to the labyrinth and involve the internal auditory canal; in such cases, traumatic transsection of the cochlear nerve is possible. The fracture lines are well visualized on axial CT images (Fig.1). An additional sign of translabyrinthine fracture is the presence of an air bubble in the labyrinth; MRI shows the presence of intralabyrinthine blood.

Extension into the facial canal occurs in 40 - 50% of cases and often causes immediate and complete facial nerve paralysis.

 

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Fig.1

Axial CT image of left temporal bone. The fracture (arrows) runs through the vestibule (v), and reaches the tympanic segment of the facial nerve canal (arrowhead) without fracturing it.
Transverse fracture, temporal bone, Fig.1