Download - forensic medicine

JIAFM, 2007 - 29(4); ISSN: 0971-0973
Fracture of the Temporal Bone: A Tomographic V/S Autopsy Study
* Dr. Mukesh Kumar Goel, ** Dr. Rashmi Goel, *** Dr. Shiv R Kochar, **** Dr. M. R. Goel,
*Asst Proff , Department of Forensic Medicine, People,s College of Medical Science Bhanpur Bhopal
(M.P.).
**Asst Proff , Department of ENT, People,s College of Medical Science Bhopal.
***Associate Proff , Department of Forensic Medicine, MGNIMS Sitapura-Jaipur.
****Dean, Principle & Controller MGNIMS Sitapura-Jaipur.
Correspondence Address:
Dr. Mukesh Kr Goyal,
Assistant Professor,
Department of Forensic Medicine,
People,s College of Medical Science Bhanpur,Bhopal (M.P.).462010.
Mobile: 09425373106
Office: 0755-4005137
e-mail- mukesh_goyal03@yahoo.co.in
Abstract
The present study was conducted in the Dep’t. of Forensic Medicine & Toxicology, SMS Medical College Jaipur
(Raj), in the period from 15 Dec. 2001 to 4 April 2002. With the aim to find out the correlation of X-ray (Skull), CT
scan (Head), Surgical intervention findings with the autopsy findings in the cases of acute Head trauma. Total of
140 cases of acute head trauma were selected irrespective of age, sex, religion caste etc. who had been admitted
in Neurosurgery dep’t. And X-ray, CT scan head and /or surgical intervention had been done, subsequently died
& autopsy was performed. X- ray skull gave batter information on fracture of skull than CT Scan, particularly when
the fracture is located on the vault or base of skull and is of linear variety [1]. 27 cases of fracture of the temporal
bone were specially studied, out of these 140 cases. All these cases had the features of triad, indicating of
fracture of petrous part of temporal bone i.e. CSF Otorrhoea 14(51.1%), 7 th nerve palsy 9(33.3%), serve middle
ear bleeding 18(66.6%) & conducting hearing loss 5(85%). The plain X-ray demonstrated the fracture of temporal
bone in 21 cases (79%) and the CT Scan demonstrated their in 24 cases (88%) Longitudinal fractures are
common in 18 cases (66%) and procedure of choice for their demonstration is lateral tomography, Transverse
fracture alone was uncommon (2cases) and can only be demonstrated in anterior posterior tomographic
projections and is usually associated with occipital fractures.
CT Scan Examination give better information in detection of fracture of temporal bone as well as the type of
fracture [2] which is essential for planning the surgical intervention or treating the patient conservatively in order
to avoid the complications like, persistent CSF otorrhoea, posterior meningitis or even death.
Key Words: RTA (Road Traffic Accident), CT Scan (head) Temporal bone fracture, Head trauma, Autopsy Head.
Introduction & Clinical Material:
The CT scanning is said to reveal promptly, accurately and non invasively the intra cranial and parenchymal
abnormalities in acute cranio-cerebral trauma that were previously recognized only at autopsy therefore the CT
scan (head) is indispensable in the diagnosis of the various traumatic lesion and their management I, it also
carries prognostic value. Fracture of petrous and tympanic part of temporal bone is not uncommon. Fracture of
petrous and tympanic part of temporal bone was identified with the aid of CT Scan and the finding was confirmed
and correlated with autopsy findings [3, 4, 5]. The present study was conducted on 140 cases of Acute Head
Trauma admitted in the Neurosurgery Department of the S.M.S. Hospital, Jaipur (Rajasthan) who died there and
subsequently postmortem examination was performed, during period Dec-2001 to Apr-2002 [ 6].
TABLE-1
Age & Gender Wise Distribution of Cases
Male Female Total
Age in Years
Number % Number % Number %
> 10 21 17.2 9 50 30 21.4
11-20 12 9.8 - 12 8.5
83