Background: One of the most serious complications of temporal bone fracture is facial nerve paralysis. Early diagnosis of traumatic facial nerve paralysis has a very crucial impact on its outcome. Reaching an optimum diagnosis requires good imaging modalities .

Objective: We aimed to determine the validity of multislice computed tomography in temporal bone fracture.

Patients and methods: We enrolled 20 patients with traumatic facial nerve paralysis secondary to temporal bone fracture with a mean age of 23.10±11.44 years. Most of the patients were males, and motor car accident was the most frequent cause of trauma. All patients had preoperative high-resolution CT(HRCT) scanning, and the results were compared with the intraoperative findings.

Results: HRCT had the highest diagnostic accuracy (95%) for the detection of the mastoid process and otic capsule fractures, followed by squamous part fracture (80%). The least diagnostic accuracy was in the detection of fracture of the posterior meatal wall (45%). Fracture of the tympanic portion of the temporal bone was present in three patients while HRCT failed to catch it. Bone chips and edema of the facial nerve were the most frequent findings intraoperatively.

Conclusion: HRCT has an additive role in the assessment of facial nerve injury in case of temporal bone fracture, but should be interpreted with caution where it might underestimate the severity in some cases.