A 25-year-old male presents to the emergency department after a road traffic accident. He has blood behind the tympanic membrane and a conductive hearing loss. A high-resolution CT scan of the temporal bone reveals a fracture line running parallel to the long axis of the petrous pyramid. Which of the following is most commonly associated with this type of temporal bone fracture?
- A Disruption of the ossicular chain ✓
- B Facial nerve injury at the perigeniculate region
- C Sensorineural hearing loss due to cochlear disruption
- D Severe vertigo due to perilymph fistula
Correct answer: A. Disruption of the ossicular chain
Explanation
C fracture line parallel to the long axis of the petrous pyramid is a longitudinal fracture, which constitutes 70 to 90 percent of temporal bone fractures. These fractures typically cause blood behind the tympanic membrane, conductive hearing loss, and ossicular disruption, most commonly at the incudostapedial joint. Sensorineural hearing loss, severe vertigo, and facial nerve injury are more characteristic of transverse fractures, which run perpendicular to the petrous axis.
Reference: Scott-Brown's Otolaryngology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.