Jones R M, Rothman M I, Gray W C, Zoarski G H, Mattox D E
Mann Ear Nose and Throat Clinic, Cary, NC, USA.
Arch Otolaryngol Head Neck Surg. 2000 Feb;126(2):131-5. doi: 10.1001/archotol.126.2.131.
To determine the incidence of intracranial injury, specifically in the temporal lobe, in patients with longitudinal fractures of the temporal bone.
Prospective inception cohort.
University of Maryland Division of Otolaryngology-Head and Neck Surgery and the Maryland Shock Trauma Center, Baltimore.
Twenty-seven consecutive patients with unilateral or bilateral temporal bone fractures.
Evaluation of temporal bone and intracranial trauma using computed tomography (CT) and magnetic resonance imaging (MRI).
Of the 27 patients enrolled in the study, 12 had the complete battery of MRI, CT, and physical and audiological examinations. In all 12 patients, MRI demonstrated adjacent middle cranial fossa meningeal enhancement. Results of non-contrast-enhanced CT and MRI demonstrated ipsilateral temporal lobe contusions in 6 of the 13 fractures for an overall incidence of 46%. In addition, MRI demonstrated 4 cerebral contusions not seen in the results of non-contrast-enhanced CT.
While high-resolution CT remains the criterion standard for evaluation of temporal bone fractures, MRI revealed a higher incidence of related temporal lobe injuries. Magnetic resonance imaging data may be valuable in preoperative evaluation of patients who require surgical intervention through a middle cranial fossa approach to document pre-existing injury and potential morbidity before retraction of the middle cranial fossa dura mater and temporal lobe.
确定颞骨纵行骨折患者颅内损伤的发生率，尤其是颞叶损伤的发生率。
前瞻性起始队列研究。
马里兰大学耳鼻咽喉头颈外科分部及巴尔的摩的马里兰休克创伤中心。
连续纳入27例单侧或双侧颞骨骨折患者。
使用计算机断层扫描（CT）和磁共振成像（MRI）评估颞骨和颅内创伤情况。
在纳入研究的27例患者中，12例接受了完整的MRI、CT以及体格检查和听力学检查。在所有12例患者中，MRI均显示中颅窝脑膜增强。非增强CT和MRI结果显示，13例骨折中有6例出现同侧颞叶挫伤，总体发生率为46%。此外，MRI还显示了4例非增强CT结果未发现的脑挫伤。
虽然高分辨率CT仍然是评估颞骨骨折的标准，但MRI显示相关颞叶损伤的发生率更高。磁共振成像数据对于需要通过中颅窝入路进行手术干预的患者的术前评估可能有价值，以便在牵拉中颅窝硬脑膜和颞叶之前记录已存在的损伤和潜在的并发症。
