Findings
- Acute nondepressed comminuted fracture of the right temporal bone extending anteriorly through the greater wing of the sphenoid bone and into the maxilla with further extension into the alveolar ridge and hard palate. Fracture lines notably involve the right carotid canal, right foramen ovale and spinosum, the right foramen rotundum, the lateral wall of the right sphenoid sinus, the right temporomandibular joint, and the right eccentric basiocciput
- There is also fracture extension from the right zygomaticosphenoid suture through the right orbital roof with adjacent extraconal hemorrhage and moderate right proptosis. Inferiorly, there is fracture involvement of the right superior orbital fissure
- Acute nondisplaced right zygomatic arch fracture
- Acute nondisplaced fracture through the lateral left pterygoid process
- Acute nondisplaced right mandibular fracture passing between the right first and second mandibular premolars with involvement of the socket of each. Temporomandibular joints remain located
- Right maxillary and sphenoid hemosinus. Inflammatory mucosal thickening of the paranasal sinuses
Diagnosis
Skull fracture, facial fractures, involvement of the superior orbital fissure and multiple skull base foramina/canals
Sample Report
Acute nondepressed comminuted fracture of the right temporal bone extending into the sphenoid bone and face, with the following notable sites of fracture extension within the skull: right carotid canal, right foramen ovale and spinosum, right foramen rotundum, lateral wall of the right sphenoid sinus, right temporomandibular joint, and the right eccentric basiocciput. Recommend CTA for further evaluation given carotid canal involvement.
Fracture involvement of the right orbital roof and right superior orbital fissure with adjacent extraconal hemorrhage and moderate right proptosis. Globe is grossly intact.
Acute nondisplaced right zygomatic arch fracture.
Acute nondisplaced fracture through the left lateral pterygoid process.
Acute nondisplaced right mandibular fracture passing between the right first and second mandibular premolars with involvement of the socket of each. Temporomandibular joints remain located.
Discussion