Department of Radiological Sciences, Diagnostic Radiology Section, University of Puerto Rico Medical Sciences Campus, Puerto Rico Medical Center, Ave Américo Miranda, PO Box 5067, San Juan, PR 00936.
Radiographics. 2011 Oct;31(6):1741-55. doi: 10.1148/rg.316115506.
The temporal bone anatomy is complex, with many critical structures in close association with one another. The temporal bone region comprises cranial nerves V, VI, VII, and VIII; vascular structures such as the internal carotid and middle meningeal arteries; sigmoid sinus; jugular bulb; and sensorineural and membranous structures of the inner ear. Most temporal bone fractures are a result of high-energy blunt head trauma. Multidetector computed tomography (CT) plays a fundamental role in the initial evaluation of patients with polytrauma in the emergency department. Multidetector CT may help identify important structural injuries that may have devastating complications such as sensorineural hearing loss, conductive hearing loss, dizziness and balance dysfunction, perilymphatic fistulas, cerebrospinal fluid leaks, facial nerve paralysis, and vascular injury. Although classifying temporal bone fractures helps physicians understand and predict trauma-associated complications and guide treatment, identifying injury to critical structures is more important for guiding management and determining prognosis than is simply classifying temporal bone fractures into a general category. Many temporal bone fractures and complications may be readily identified and characterized at routine cervical, maxillofacial, and head multidetector CT performed in patients with polytrauma, without the need for dedicated temporal bone multidetector CT. Dedicated temporal bone multidetector CT should be considered when there is a high degree of suspicion for temporal bone fractures and no fractures are identified at head, cervical, or maxillofacial CT.
颞骨解剖结构复杂，许多关键结构相互靠近。颞骨区域包含颅神经 V、VI、VII 和 VIII；血管结构，如颈内动脉和脑膜中动脉；乙状窦；颈静脉球；以及内耳的感觉神经和膜性结构。大多数颞骨骨折是高能钝性头部创伤的结果。多排 CT（Multidetector Computed Tomography，MDCT）在急诊科多发伤患者的初始评估中起着重要作用。MDCT 有助于识别重要的结构损伤，这些损伤可能导致灾难性的并发症，如感觉神经性听力损失、传导性听力损失、头晕和平衡功能障碍、迷路瘘、脑脊液漏、面神经瘫痪和血管损伤。虽然分类颞骨骨折有助于医生了解和预测与创伤相关的并发症，并指导治疗，但识别关键结构的损伤对于指导管理和确定预后比简单地将颞骨骨折分类为一般类别更为重要。在多发伤患者中进行常规颈椎、颌面和头部 MDCT 检查时，许多颞骨骨折和并发症可以很容易地识别和描述，而无需专门的颞骨 MDCT。当高度怀疑颞骨骨折而头部、颈部或颌面 CT 未发现骨折时，应考虑进行专门的颞骨 MDCT。
