Fracture of the temporal bone: A tomographic v/s autopsy study

The present study was conducted in the Dep't. of Forensic Medicine & Toxicology, SMS Medical College Jaipur (Raj), in the period from 15 Dec. 2001 to 4 April 2002. With the aim to find out the correlation of X-ray (Skull), CT scan (Head), Surgical intervention findings with the autopsy findings in the cases of acute Head trauma. Total of 140 cases of acute head trauma were selected irrespective of age, sex, religion caste etc. who had been admitted in Neurosurgery dep't. And X-ray, CT scan head and/or surgical intervention had been done, subsequently died & autopsy was performed. X-ray skull gave batter information on fracture of skull than CT Scan, particularly when the fracture is located on the vault or base of skull and is of linear variety [1]. 27 cases of fracture of the temporal bone were specially studied, out of these 140 cases. All these cases had the features of triad, indicating of fracture of petrous part of temporal bone i.e. CSF Otorrhoea 14(51.1%), 7th nerve palsy 9(33.3%), serve middle ear bleeding 18(66.6%) & conducting hearing loss 5(85%). The plain X-ray demonstrated the fracture of temporal bone in 21 cases (79%) and the CT Scan demonstrated their in 24 cases (88%) Longitudinal fractures are common in 18 cases (66%) and procedure of choice for their demonstration is lateral tomography, Transverse fracture alone was uncommon (2cases) and can only be demonstrated in anterior posterior tomographic projections and is usually associated with occipital fractures.

CT Scan Examination give better information in detection of fracture of temporal bone as well as the type of fracture [2] which is essential for planning the surgical intervention or treating the patient conservatively in order to avoid the complications like, persistent CSF otorrhoea, posterior meningitis or even death.