Temporal bone fractures. State of the art review.

Advances in technology and otomicrosurgery have dramatically changed the management of temporal bone fractures. Based upon our experiences and a review of the literature, the following recommendations are made: The complete temporal bone surgeon should have access to a late-generation CT scanner and have a good working relationship with a neuroradiologist. The surgeon should be capable of repairing the facial nerve within the internal acoustic meatus, by both middle fossa and translabyrinthine approaches. It is advantageous to follow the progress of cochlear implantation. One should be knowledgeable about the electrophysiologic diagnosis of facial paralysis and know when to be conservative in facial palsy secondary to head trauma.