Temporal Bone

The Temporal Bone comprises of 5 parts:

1. Squamous
2. Mastoid
3. Tympanic (more prominent on the lateral surface)
4. Styloid process
5. Petrous (more prominent on the medial surface)
Temporal bone make:
1. the lateral surface of the skull
2. 2/3 of the middle cranial fossa
3. 1/3 of posterior cranial fossa
1- Squamous part:
 Is the site for temporal craniotomy
 Forms the roof of the external auditory canal part of the tegmen tympani
 Articulates with
1. greater wings of the sphenoid bone
2. parietal bone
3. occipital bone
2- Petrous part:
 Extends anteriomedially at 45 degree angle between the basioccipit & greater wings of the sphenoid bone
 Forms part of tegmen tympani of tympanic cavity
 The Eustachian Tube is located along the Junction between the petrous portion & greater wings of the sphenoid
 Carotid canal position in the petrous part:
 posterior to the Eustachian tube and sphenoid spine
 medial to Glenoid fossa
 anterior to the styloid process
 separated from the internal jugular by the cartoticojugular bone from the carotid canal
 The apex of the petrous bone:
 part of the temporal bone anterior to the internal auditory meatus (part of petrous bone)
 at the apex trigeminal nerve pass into meckle’s cave with the abducent nerve passing close to its roof
 Meckel’s cave is the concavity on the superior portion of the temporal bone in which the gasserian ganglion (V) is located.
 Dorello’s canal is between the petrous tip and the sphenoid bone, contains the VI nerveand inferior petrosal sinus
 wedged between: posterior border of the greater wings of the sphenoid and basilar part of the occipital bones
 Gradenigo’s syndrome: is the result of infection at the petrous apex and comprises lateral rectus palsy, facial
pain an ear discharge.
 boundaries are marked by:
1. the superior and inferior petrosal sinuses above and below
2. Horizontal segment of the internal carotid artery (lCA) and Eustachian tube laterally.
 Foramen lacerum:
o the apex of petrous bone, basioccipit & greater wings do not completely fuse, producing foramen lacerum
o The apex of the petrous form the posteriolateral part of the foramen lacerum
o Foramen lacerum is closed by fibrocartilage and transmits emissary vessels+ ICA goes through it only

 The petrous pyramid is the strongest bone in the body.

3- Tympanic plate:
 Lies lateral to the carotid canal and jugular foramen
 Forms:
 Lateral part: anterior, inferior & part of the posterior bony part of the external auditory canal
 Medial part: the floor of the hypotympanum of the middle ear
 Articulates:
 Anteriorly: squamous bone of glenoid fossa (squamotympanic fissure)
 Posteriorly: mastoid bone (tympanomastoid fissure)
 the medial portion of the squamotympanic fissure is divided by extension of
the petrous bone from the margin of tegmen tympani
 Note: tegmen tympani is the roof of middle ear and is made of squamous &
petrous bone
 This extension forms:
 Anteriorly: petrosquamous fissure
 Posteriorly: petrotympanic fissure
4- Styloid process:
 It is derived from the 2nd pharyngeal arch
 2.5cm in length
 Located :
 Posterior to the tympanic plate
 Lateral to the jugular foramen
 Is a landmark for the main trunk of the facial nerve which is located lateral &
superior to the base of the Styloid process (Styloid process is deep to the
facial nerve)
 Can be palpated via the tonsillar fossa
 Easily seen on plain X-RAY
 Elongated styloid process can lead to referred oropharynx +otalgia by
stretching the glossopharyngeal nerve
 It is the attachment site for 3 muscles:
1. Styloglossus: hypoglossus nerve
2. Stylohyoid: facial nerve
3. Stylopharyngeus (from medial aspect): glossopharngeus nerve
 Note:
 stylohyoid ligament extends into the lesser cornu of the hyoid bone,
thus binding the hyoid bone to the skull base
5- Mastoid process:
 Stylomastoid foramen lies posterior to the Styloid process
 transmits: facial nerve, stylomastoid artery
 Digastric groove: runs posteriorly from the Stylomastoid foramen, gives
attachment to the digastrics muscle
 The sulcus for occipital artery lies medial to the Digastric groove
 Muscles connected to the mastoid process:
1. SCM
2. Posterior belly of digastrics muscle
3. Anterior, superior, posterior auricular muscle
4. Splenius capitus
5. Longissimus capitus
Note: the temporalis muscle is attached to the squamosa
 80 % of the mastoids are pneumatized
 Mastoid is fully pneumonitized at the age of 2 years
 Development of mastoid air cell system does not occur until after
birth, about 90% of cell formation being completed at the age of 6
and the remaining 10% take place up to the age of 18
 Diploic mastoid: mastoid that is occupied by bone marrow instead of air cell
 The antrum, but not the air cells, is well developed at birth, and by adult life has a 2 ml volume, and may be the
only air-filled space in the process when it’s of the sclerotic type.
Surfaces of the temporal bone:
Lateral surface of Temporal Bone:
Tympanosquamous Fissure: deep auricular artery
Petrotympanic Fissure (Glaserian):
 slit in the anterior part of the medial aspect of the lateral wall
 2 mm long
 opens just above the attachment of the tympanic membrane
 This fissure connects the middle ear cavity to the T.M.J &
parotid gland and can be the route of infection
 Content of petrotympanic fissure:
 receives the anterior malleolar ligament
 Transmits anterior tympanic branch of the maxillary artery
 Canal of Huguier (anterior canaliculus):
 located in the medial end of the petrotympanic fissure
lateral to the roof of the protympunum
 transmits the chorda tympani nerve
Note: protympunum is the most anterior part of middle ear cavity
bounded by the ET opening superiorly & carotid canal anteriorly
Tympanomastoid Fissure:
 May allow infection in malignant otitis externa to extend from the
external auditory canal to the skull base
 may contain arnold’s nerve Branch of the vagus nerve
Suprameatal spine of Henle:
 Variable in size surgical landmark of the antrum
 Note: the antrum is part of the petrous portion of temporal bone
that opens :
 Anteriorly Via aditus into the tympanic cavity (epitympanum)
 posteriorly into the mastoid air cells
Cribriform area:
 Small communication between antrum & lateral mastoid cortex through
which pus from the mastoid may drain and form subperiosteal abscess.
 So acute otitis media in infants are actually subperiosteal infection
Mastoid Foramen:
 Transmits
 mastoid artery (branch of occipital artery)
 Emissary Vein from the soft tissue overlaying the mastoid cortex to
the lateral venous sinus
Middle fossa surface of Temporal Bone
Arcuate Eminence:
 Prominence of the most superior part of superior semicircular
canal located on the superior surface of petrous bone
 An important surgical land mark in the middle cranial fossa
approach
Hiatus of Facial canal:
 It Has variable size
 Located at the anterior surface of petrous bone & Contains:
 Geniculate ganglion of facial nerve
 Greater Superficial petrosal Nerve
 superficial petrosal branch of middle meningeal artery
 clinical application of facial hiatus:
 the arcuate eminence & hiatus of facial canal are used as land
marks of internal auditory canal in the middle cranial fossa
approach
 genigulate ganglion lies deep to facial hiatus ,but is 5-10% of
people it lies under the dura within the hiatus without bony
coverage
Superior tympanic canaliculus:
 Located in the petrosquamous fissure & contains
 Lesser superficial petrosal nerve
 Superior tympanic artery ( branch of middle meningeal artery)
Posterior surface of the temporal bone:
Meatus of the internal auditory canal (porous acusticus internus):
The Internal auditory canal:
 short canal (nearly 1 cm in length)
 Passes into the posterior surface of petrous bone in a lateral
direction from the Cerebellopontine Angle
 starts at the porus acousticus & ends at the fundus (which
contains meatal foramen ,the beginning of fallopian canal)
 porus acousticus: is the inner medial opening of the Internal
auditory canal
 Fundus: lateral outer end
 connects the inner + middle ear with the posterior cranial
fossa
 lined with dura
 Within the fallopian canal the dural covering of the facial nerve is transformed into
epineurium
 The meatus is closed at its outer lateral end (fundus), by a plate of bone that is
perforated for the passage of nerves and blood vessels to and from the cranial
cavity.
 The transverse crest (falciform crest) divides the IAC into superior (small) and inferior
(larger) compartments.
 The superior portion in turn further divide by the smaller & more laterally located
vertical crest or Bill’s bar
 At this lateral portion of the canal the anatomy is the most consistent
 Content of internal auditory canal:
 Superior-anterior (facial/fallopian canal): facial Nerve
 Superior Posterior: superior vestibular Nerve which supply:
 Crista of superior semicircular canal
 Crista of lateral semicircular canal
 Macule of utricle
 upper part of saccule's macule
 Inferior-Posterior:
 Contains Inferior vestibular Nerve
 has 2 foramenae
1. Saccular fossa: contains saccular nerve which supply lower part of
Saccule's macula
2. Singular foramen:
o lies behind and below the inferior vestibular foramen
o contains the singular nerve (posterior ampullar
branch).
o This runs obliquely through the petrous bone close to
the round window to supply the sensory epithelium
in the ampulla of the posterior semicircular canal.
o Singular nerve (posterior ampullar branch) is
approached by drilling below the round window
membrane
 INFerior-ANTerior: cochlear Nerve
 The average IAC diameter is 6.8mm & the max diameter is 8 mm
 IAC diameter more than 8 mm is suspicious of shwanomma
 contains: scapa's ganglion
 Note: the superior vestibular nerve communicates with facial nerve via Oort nerve
 Note: the fundus is the entrance to the fallopian canal
1) Subarcuate Fossa: Opening of petromastoid foramen containing subarcuate artery
(branch of labyrinth artery) Or inferior cerebellar artery
2) Aperture of vestibular aqueduct (cotugno): Lies in the foveate impression covered by
operculum, Parallel to the cochlear aqueduct, Contains the endolymphatic duct & sac
+small vein
Base View of the Temporal Bone:
1. Stylomastoid foramen
2. Digastric groove
3. Jugulocarotid spine: Erosion of it if visible on CT scan
indicates a lesion o jugular foramen
4. Inferior Tympanic canaliculus:
 Transmit:
1- tympanic branch of the glossopharyngeal nerve
2- inferior tympanic artery (a branch of ascending
pharyngeal artery)
5. Aperture of Cochlear canaliculus:
 Contains periotic duct that connects between the salca
tympani (which contains perilymph) & subarachnoid
space
 Lies medially between the carotid canal & jugular fossa
 Filled with loose subarachnoid tissue
So the temporal bone has 4 openings:
Foramen Content Location
Internal auditory canal Facial nerve Post surface(lateral)
Vestibulocochlear nerve
Internal auditory artery
Subarcuate fossa Subarcuate artery Post surface(mid)
Aperture of vestibular aqueduct Endolymphatic duct & part of sac, Vein Post surface(inferiomedial)
Cochlear aqueduct Connects scala tympani & subarchanoid space Inferior/base surface

Foramen/fissure Passing nerve Passing artery or vein

Squamotympanic fissure
Petrosquamous fissure which
contains superior tympanic
canaliculus
Petrotympanic fissure
Tympanomastoid fissure
Inferior tympanic canaliculus in
jugulocarotid ridge
Stylomastoid foramen
Mastoid foramen
Facial hiatus
Meatus of internal auditory canal
Subarcuate fossa (opening of
petromastoid foramen)
Continuation of Jacapson’s Nerve
( glossopharyngeal nerve)
Lesser petrosal nerve
Chordi tympani Nerve (facial nerve)
Arnold’s nerve(vagus)
Jacapson’s Nerve
Facial nerve
Greater Petrosal Nerve
Facial Nerve
Vestibulocochlear Nerve
Deep auricular artery (1st branch of internal
maxillary artery)
Superior tympanic artery
Anterior tympanic artery (2nd branch of
internal maxillary artery)
Anterior malleur ligament
Inferior tympanic artery
Post tympanic artery
Mastoid artery (branch of occipital a)
Superficial petrosal artery
Labyrinthine artery
Subarcuate artery
Inferior cerebellum artery

Source of blood vessel Name of the blood vessel Entry point

Maxillary artery Anterior tympanic artery Petrotympanic fissure
Ascending pharyngeal artery Inferior tympanic artery Inferior tympanic canaliculus
Stylomatoid branch of post auricular artery Posterior tympanic artery Stylomastoid foramen
Middle meningeal artery Superior tympanic artery Superior tympanic canaliculus
 Suprameatal / Macewen triangle

suprameatal crest ( temporal line of the squamous part of the temporal bone)
 ridge of bone forming the upper edge of the bony meatus
 continuation backward of the posterior root of the zygoma
 corresponds to the floor of the middle cranial fossa
suprameatal spine /spine of Henle :
 upper and posterior edge of the meatus which is formed by a thin, small shell or edge of bone running from the
suprameatal crest downward and backward to the posterior wall
suprameatal fossa:
 triangular in shape depression Behind the suprameatal spine and between it and the posterior portion of the
suprameatal crest
suprameatal triangle of Macewen’s :
 Located posterior superior to the EUC
1) upper border: suprameatal crest
2) anterior border: suprameatal spine
3) Posterior border: tangent drawn from the posterior margin of the opening of the external canal (the ridge of
bone, running from the posterior portion of the crest to the lower portion of the spine).
 Superficial (surface) landmark of the mastoid antrum through which the antrum may be reached medially.
o Tegmen mastoideum is the thin plate over the antrum.
 The mastoid antrum is 1.5 cm deep to this land mark (2mm at birth and increase 1 mm/ year till adulthood)
 In children McEwen's triangle is marked by small perforations through which pass the small blood vessels (cribrosa
area)
So the following structures are surface landmark for mastoid antrum in mastoidectomy:
1) Temporal line
2) Suprameatal spine
3) Cribrosa area
Tegmen mastoid:
 thin plate covering the mastoid
 This plate in infant is microscopically cribriform therefore otitis media is actually subperiosteal infection