<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Temporal bone fractures are traditionally classified as transverse, longitudinal or mixed fractures depending on their relationship to the petrous pyramid. However recent studies show that classifying temporal bone fractures as otic capsule sparing (OCS) and otic capsule violating (OCV) types has more relevance with the prognosis of hearing loss and other associated complications. To assess the predictive value of two different types of temporal bone fracture classification systems with respect to hearing loss and its type.</span></p><p class="abstract"><strong>Methods:</strong> This prospective study was done on patients attending a tertiary care hospital in the study period of one year. Temporal bone fracture patients satisfying inclusion and exclusion criteria were clinically and audiologically evaluated. All patients with temporal bone fractures were categorized into two groups - Longitudinal/ Transverse (old) and OCS / OCV (new). <span lang="EN-IN">Hearing loss was evaluated audiologically on multiple intervals- initially following the injury once the patient is stable, later after a gap of 1 month and 3 months following the injury. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">During the study period, 45 patients presenting with temporal bone fractures who satisfied the selection criteria were evaluated. The correlation was statistically significant for new classification system (<em>P</em>- 0.000) with respect to severity and prognosis of hearing loss which was not the case with the old system (<em>P</em>- 0.450). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We found that classifying temporal bone fractures into OCV and OCS correlates well with the severity of the hearing loss, the prognosis of the patient and the residual hearing disability when compared to the traditional system.</span></p>

<p>Osteoma is a benign slow growing bone tumour with predominance in long bones, and is rare in the skull. They are a rare occurrence in the mastoid temporal bone, being usually asymptomatic and treated mainly for cosmetic reasons. We report a case of a young female who presented with a history of swelling in the left post aural region since 10 years. Swelling was gradually increasing in size and was painless. Patient underwent excision of the tumour without any significant complication. As per our knowledge this appears to be the largest tumour reported in literature. The clinical presentation and radiological features of osteoma are characteristic but differential diagnosis should include eosinophilic granuloma, giant cell tumour, monostotic fibrous dysplasia, solitary variant of multiple osteoma, and osteoblastic metastasis. Osteomas present on the mastoid or squamous portion of the temporal bone need to be dealt for cosmetic purposes or if they are causing symptoms, while surgery should include careful removal of periosteal cover and safe margin of the mastoid cortex around it. </p>