Longitudinal versus transverse petrous temporal bone fracture

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Petrous temporal bone fractures are classically divided into longitudinal, transverse or mixed fracture patterns depending on the direction of fracture plane with respect to the long axis of the petrous temporal bone. Some features may aid in distinguishing them.             

Longitudinal petrous temporal bone fracture

  • most common of all petrous temporal bone fracture (70-90%)
  • fracture line is parallel to the long axis of petrous temporal bone
  • otic capsule is spared
  • ossicles are often involved resulting in conductive hearing loss
  • involvement of the tympanic membrane
  • facial nerve involvement (~25%)

Transverse petrous temporal bone fracture

  • less common temporal bone fracture (20-30%)
  • fracture line is perpendicular to the long axis of petrous temporal bone
  • otic capsule is often involved resulting in sensorineural hearing loss
  • ossicles and the tympanic membrane are usually spared
  • facial nerve involvement (~50%)
Fractures