A Temporal Bone Fracture Involving the Superior Semicircular Canal

Case Report

Austin J Otolaryngol. 2014;1(4): 2.

A Temporal Bone Fracture Involving the Superior Semicircular Canal

Hong Chan Kim, Hyung Chae Yang, Yong Beom Cho and Chul Ho Jang*

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hospital, South Korea

*Corresponding author: Chul Ho Jang, Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 501-757, South Korea

Received: October 10, 2014; Accepted: November 14, 2014; Published: November 17, 2014

Abstract

Temporal bone fractures typically take the path of least resistance, which is along structurally weakened points such as the various foramina perforating the skull base. The superior semicircular canal has a relatively thicker bony structure than surroundings. As a result, the fracture proceeds otic capsules typically fractures the surrounding structures. Here, we present the first case of a temporal bone fracture involving the superior semicircular canal and demonstrate its high-resolution computed tomography image.

Keywords: Head injuries; Closed; Temporal bone; Semicircular canals; Temporal bone fracture

Case Presentation

A 45 year-old man who fell off from a height of 3m was referred to the ENT department for otolaryngologic evaluation. He was admitted to the intensive care unit because of a closed head injury with multiple scalp lacerations, right hearing impairment and headache. The skull X-ray showed a right temporal bone fracture. The initial brain computed tomography (CT) scan revealed an acute epidural hematoma (EDH) along the right parieto-temporo-occipital convexity with pneumocephalus, and right temporal bone fracture.

The patient was alert and oriented; however, he had a severe headache at that time. His responses to the doctor’s orders were somewhat restricted. No facial paralysis was noted. He complained of non-whirling type dizziness and right sided hearing impairment. Computed dynamic postulography showed a vestibular pattern; however, nystagmus was absent. Pure tone audiometry revealed a mixed type severe hearing impairment (Figure 1A).