Comparison of the Traditional and New Classification System of Temporal Bone Fractures for Clinical Relevance

Abstract

Objective: The traditional classification of temporal bone fracture is subdivided into transverse, longitudinal, and mixed fracture. But questions have arisen about its limited correlation with clinical symptoms. Recent studies have been introduced, including petrous bone invasion and otic capsule violation. And a newer system is introduced about invasion of four areas of temporal bone.

Method: Clinical records and computed tomography scans were reviewed retrospectively on patients diagnosed with temporal bone fractures for the last seven years. We evaluated correlations of clinical presentation with each category of temporal bone fracture.

Results: A total of 129 temporal bone fracture patients were reviewed. In the traditional classification scheme, transverse fracture presented at a significantly higher rate of sensorineural hearing loss (SNHL). The invasion of petrous bone system showed a significantly higher rate of SNHL, dizziness, and perforation of the tympanic membrane. The otic capsule-based system demonstrated a statistically significant rate and severity of SNHL among patients with otic capsule violation (P < .05).

Conclusion: Although the traditional classification scheme, otic capsule involvement, and four areas of temporal bone systems did not demonstrate clear clinical correlations, petrous bone involvement showed significant correlations. So a petrous involvement based scheme better reflects clinical aspects.