Types of Temporal Bone Fractures That Can Cause Facial Paralysis

Temporal bone fractures are a significant cause of facial paralysis, with the transverse type being the most commonly associated. This type of fracture typically occurs due to direct trauma to the back of the head, often resulting in severe inner ear damage. The cochlea and semicircular canals may also experience hemorrhaging. Patients with labyrinthine injury frequently suffer from symptoms such as vertigo, nausea, and vomiting. Approximately half of those affected may develop facial paralysis as a complication.

Longitudinal Fractures and Their Effects

Another common type of temporal bone fracture is the longitudinal fracture. This usually results from direct impact to the temporal or top region of the skull. It is often accompanied by fractures or dislocations of the ossicles in the inner ear, as well as damage to the tympanic cavity. Additional symptoms may include a ruptured eardrum, bleeding from the external auditory canal, or complications such as meningeal laceration and cerebrospinal fluid (CSF) leakage from the ear. In some cases, this type of fracture can also affect the facial nerve, leading to facial paralysis.

Less Common Fractures: Petroclival Fractures

Impact on Cranial Nerves

A less common but clinically significant type of temporal bone fracture is the petrous apex fracture. These fractures often injure the cranial nerves, leading to a variety of neurological symptoms. Patients may experience ptosis (drooping of the upper eyelid), dilated pupils, restricted eye movement, double vision, or strabismus. In some cases, damage to the trigeminal nerve can result in trigeminal neuralgia, causing intense facial pain.