Role of High-resolution Computed Tomography in the Evaluation of Temporal Bone Fracture

Introduction: Skull base and temporal bone fractures are frequently associated with severe high-velocity head trauma. Even though most of these fractures are not life-threatening, they are often associated with severe morbidity which has got a major impact on the quality of life. Conventional computed tomography (CT) has got its own limitations and often missed finer details of the temporal bone fractures. Hence, it is imperative to include high-resolution CT (HRCT) in the armamentarium of the investigations for head injury. Aim: This study aims to define the diagnostic value of the HRCT in temporal bone fractures and also to highlight the superiority of HRCT over conventional CT in defining the extent of the fracture. Materials and Methods: This study involved patients with head injury who had been admitted to Government Rajaji Hospital, Madurai Medical College, irrespective of age/Glasgow coma scale score with symptoms/signs suspicious of temporal bone fracture. All patients were underwent both conventional and HRCT. The difference in the rate of detection of temporal bone fractures in both the techniques was compared and analyzed. Results: Among the total of 60 enrolled patients, 20 patients were not having temporal bone fractures. Of the remaining 40 patients, conventional CT can pick up only 15 fractures. However, HRCT diagnosed temporal bone fractures in all 40 patients. We have found statistically significant difference in fracture detection rate between HRCT and conventional CT. Conclusion: HRCT of temporal bone is more sensitive and specific than conventional CT in diagnosing temporal bone trauma. HRCT is highly efficient in assessing the extent of the fracture line in temporal bone trauma.