Diagnostic Evaluation of Temporal Bone Trauma ... - For Members

2003 ASNR Annual Meeting Abstracts
03-CAE-996-ASNR
Diagnostic Evaluation of Temporal Bone
Trauma: Review of Fracture
Classification, Assessment of
Complication, and Clinical Management
Author(s):
Hartman, M. J.·Gentry, L. R.
University of Wisconsin
Madison, WI.
Purpose
To provide a comprehensive training module for radiology residents and neuroradiology
fellows for diagnostic evaluation and clinical management of patients with temporal bone
trauma. The main focus of this computer-aided exhibit will be to review the current
classification systems, demonstrate the common complications of temporal bone trauma
(facial nerve palsy, conductive hearing loss, vascular injuries, sensorineural hearing loss,
CSF leaks, vestibular symptoms), and to review important clinical management decisions
in these patients.
Materials & Methods
Diagnostic images and medical records of 100 consecutive patients with temporal bone
fractures and were reviewed retrospectively. The clinical information was reviewed
specifically for evidence of common complications related to temporal bone fracture.
Results
The fractures were analyzed by the traditional classification system [transverse, (n = 5)
longitudinal (n = 74), complex (n = 20), other (n = 1) as well as a more recently proposed
classification system (labyrinthine (n = 25), extra-labyrinthine (n = 75)]. Bilateral
fractures were present in 19% of patients. The frequencies of different types of
complications were assessed for each of these classification systems. The newer
classification system allowed more uniformity in the classification of the fractures and
more consistently predicted associated clinical complications when compared with the
traditional classification system. Sensorineural hearing loss, ossicular injuries, facial
nerve palsy, vascular injuries, and CSF leaks were the most common clinical
complications identified.
Conclusion
This hypertext-driven computer-aided exhibit attempts to train radiology resident to
systematically evaluate patients with fractures of the temporal bone. The goal is to teach
residents to accurately classify temporal bone fractures and to properly evaluate the
© 2003 ASNR. All rights reserved.

2003 ASNR Annual Meeting Abstracts
patient for the most common clinical complications. This training module reviews the
merits of traditional and newer classification systems for temporal bone trauma. The
module systematically reviews the common clinical complications that occur with these
fractures and depicts the typical diagnostic appearance of these complications on
multimodality imaging. Diagnostic protocols for assessment of facial nerve palsy, hearing
loss, CSF leaks, and vascular injuries are notably emphasized. A pre and posttest
assessment allows residents to monitor their learning progress.
© 2003 ASNR. All rights reserved.