ENT Department Timisoara

2nd Timisoara International Course on

Middle Ear Surgery with
Temporal Bone Dissection

TEMPORAL BONE
ANATOMY
Temporal bone at birth. Outer aspect

(After Gray, 1989)

Temporal bone at birth. Inner aspect

(After Gray, 1989)

LEFT TEMPORAL BONE (OS TEMPORALE),
OUTER SURFACE

The temporal bones are

situated at the sides and
base of the skull. Each
4 3
consists of five parts, the
2 squama (1), the petrous
(3), mastoid (2), tympanic
5
part (4), and the styloid
process (5).

(After Gray, 1918)

MASTOID PROCESS
TEMPORAL BONE AND ITS RELATIONS WITH THE
SURROUNDING BONES
TEMPORAL BONE AND ITS RELATIONS WITH THE
SURROUNDING BONES
TEMPORAL BONE (PINK)
 Mastoid Portion (Pars mastoidea)
Surfaces
• The mastoid portion forms the posterior part of the bone.
• Its outer surface is rough, and gives attachment to the
Occipitalis and Auricularis posterior muscles.
• It is perforated by numerous foramina; one of these, of
large size, situated near the posterior border, is termed
the mastoid foramen; it transmits a vein to the transverse
sinus and a small branch of the occipital artery to the
dura mater.
• The position and size of this foramen are very variable; it
is not always present; sometimes it is situated in the
occipital bone, or in the suture between the temporal and
the occipital.
The mastoid portion is continued below into a conical
projection, the mastoid process, the size and form of
which very somewhat; it is larger in the male than in
the female.
This process serves for the attachment of the
Sternocleidomastoideus, Splenius capitis, and
Longissimus capitis muscles.
On the medial side of the process is a deep groove,
the mastoid notch (digastric fossa), for the attachment
of the Digastricus muscle; medial to this is a shallow
furrow, the occipital groove, which lodges the occipital
artery.
  The inner surface of the mastoid portion
presents a deep, curved groove, the sigmoid
sulcus, which lodges part of the transverse
sinus; in it may be seen the opening of the
mastoid foramen.
The groove for the transverse sinus is
separated from the innermost of the mastoid air
cells by a very thin lamina of bone, and even
this may be partly deficient.
PETROMASTOIS PART-
CEREBELLAR SURFACE

(AFTER GRAY, 1918)

 Borders
The superior border of the mastoid portion
is broad and serrated, for articulation with the
mastoid angle of the parietal bone.
The posterior border, also serrated,
articulates with the inferior border of the
occipital between the lateral angle and jugular
process. Anteriorly the mastoid portion is
fused with the descending process of the
squama above; below it enters into the
formation of the external acoustic meatus and
the tympanic cavity.
 The petrosal portion contains the cavity of the middle ear
and all the ear ossicles;the Malleus, Incas and Stapes.
 This portion projects anterior and medialy beneath the
skull.
 Projecting inferiorly from the petrosal portion is the
slender Styloid Process which is of variable length.
 The styloid process serves as a muscle attachment for
various thin muscles to the tongue and other structures
in the throat.
 Externaly the petrosal portion possesses the External
Auditory Meatus while internally there is an Internal
Auditory Meatus.
 Anterior to the external meatus the Zygomatic Process
has its origin.
 This process projects forward toward the face and its
articulation with the temporal process of the zygomatic.
Just anterior of the external meatus and
inferior of the origin of the zygomatic process
is the Glenoid or Mandibular Fossa which
assists in forming the shallow socket of the
Tempro-Mandibular Joint.
 Posterior to the external auditory meatus is
the inferiorly projecting Mastoid Process
which serves as an attachment for the
sternocleidomasotid muscle.
 Above the mastoid process is the
Supramastoid Crest to which the posterior
portion of the temporal muscle is attached.
 Coronal section of right temporal
bone
A section of the mastoid process
shows it to be hollowed out into a
number of spaces, the mastoid cells,
which exhibit the greatest possible
variety as to their size and number.

At the upper and front part of the

process they are large and irregular
and contain air, but toward the lower
part they diminish in size, while those
at the apex of the process are
frequently quite small and contain
marrow; occasionally they are entirely
absent, and the mastoid is then solid
throughout.

(After Gray, 1986)

In addition to these a large irregular cavity is situated at
the upper and front part of the bone. It is called the
tympanic antrum, and must be distinguished from the
mastoid cells, though it communicates with them.

Like the mastoid cells it is filled with air and lined by a

prolongation of the mucous membrane of the tympanic
cavity, with which it communicates.

The tympanic antrum is bounded above by a thin plate of

bone, the tegmen tympani, which separates it from the
middle fossa of the base of the skull; below by the
mastoid process; laterally by the squama just below the
temporal line, and medially by the lateral semicircular
canal of the internal ear which projects into its cavity.
It opens in front into that portion of the tympanic
cavity which is known as the attic or epitympanic
recess.
The tympanic antrum is a cavity of some
considerable size at the time of birth; the mastoid
air cells may be regarded as diverticula from the
antrum, and begin to appear at or before birth; by
the fifth year they are well-marked, but their
development is not completed until toward
puberty.
 OCCIPITOMASTOID SUTURE

Temporal bone
is in purple,
and mastoid
portion is
immediately to
the left of the
tip of the arrow

(After Gray, 1989)

The inferior or outer surface of the skull base

1) Squamous part of the

temporal bone.
2) Mastoid part of the temporal
bone.
3) Mastoid process (attachment site
for muscles sternocleidomastoid,
splenius capitis, longissimus capitis
1 and auricularis posterior)
5 4) Mastoid incisure (origin of
1
3 digastricus).
4
5) Mastoid foramen (passage for an
2 emissary vein of Santorini or
posterior meningeal artery).

(After Gray,1989)
 The interior base of the skull

1) Squama of the temporal bone

2) Petrous portion of the temporal
bone
3) Mastoid process of the temporal
bone
1 4) Mastoid foramen
2

4
3

(After Gray, 1989)

 The left temporal bone inner surface
1)Squamous part

2) Mastoid part

3) Petrosal part
1
4) Mastoid process
6
5) Mastoid foramen
3
2 5 6) Petrous margin or angle
(posterior border of the
petrous part of the
temporal bone)
4

(After Gray, 1989)

The left temporal bone seen from outside

1) Squamous part
1
2) Mastoid part
3) Petrosal part
4) Mastoid process
5) Mastoid foramen
(stylomastoid foramen)
6) Mastoid incisure (digastric
2 or mastoid groove)
3 5
4
6

(After Gray,1989)
 Temporal bone, sagittal section

1. Antrum
mastoideum
2. Canalis nervi
facialis
3. Foramen
stylomastoideum
1 4. Proc. Mastoideus

After Sobotta
 Temporal bone, sagittal section

1. Canalis nervi facialis

2. Cavitas tympani
3. Cellulae mastoideae
4. Fissura tympanomastoidea
5. Pars petrosa
6. Pars tympanica
7. Proc. Mastoideus
11 2 8. Proc. Styloideus
6 9. Vagina processus styloidei

3
5 4

7 8

After Sobotta
 ADULT HUMAN SKULL, LATERAL VIEW

1 1. PETROUS PART
2. PETROMASTOID
PART
3. TYMPANIC PART
4. STYLOID PROCESS
3

2
4

Personal photo
 ADULT HUMAN SKULL, INFERIOR VIEW

1. Styloid process
2. Mastoid process
3. Stylomastoid foramen
1

3
2

Personal photo
 ADULT HUMAN SKULL, INFERIOR VIEW

1.Mastoid process
2. Squamous part

4 3.Occipitotemporal
suture

7 4. Styloid process
5
5. Stylomastoid
1 foramen
6.Mastoid foramen
7. External acustic
2
6 meatus
3

PERSONAL PHOTO
 ADULT HUMAN SKULL, INFERIOR VIEW

1. Mastoid incisure
2. Stylomastoid
foramen
3. Styloid process
3
4. Mastoid process
2
4
1

Personal photo
 ADULT HUMAN SKULL, LATERAL VIEW

1.Squamous part
2. Tympanic part
1
3.Zygomatic
process
4. Petromastoid
part
4
2 5. Mastoid
3 process

PERSONAL PHOTO
 Adult human skull, lateral view

1.Squamous part
1 2. Petromastoid
part
3. Tympanic part
4. Zygomatic
process
5. Mastoid process

4 3 2

Personal photo
 Adult human skull, inferior view
1.Anterior Palatine Foramen 2. Palatine Process of
Maxilla 3. Palatine 4. Greater Palatine Foramen 5.
Lesser Palatine Foramen 6. Pterygoid Processes of
Sphenoid 7. Zygomatic Process 8. Squamous Part of
Temporal Bone 9. Mandibular Fossa 10. Styloid
Process 11. Stylomastoid Foramen 12. Mastoid
Process 13. Mastoid Foramen 14. Superior Nuchal
Line 15. External Occipital Protruberance 16. Median
Nuchal Line 17. Inferior Nuchal Line 18. Foramen
Magnum 19. Condyloid Canal 20. Occipital Condyle
21. Hypoglossal Canal 22. Jugular Foramen 23.
Carotid Canal 24. Foramen Spinosum 25. Foramen
Ovale 26. Foramen Lacerum 27. Vomer 28.
Transverse Palatine Suture 29. Median Palatine
Suture

(after McMinn, 1999)

Facial nerve branches

(After BYG,2006)
 STYLOMASTOID FORAMEN

STYLOMASTOID
FORAMEN
(BLACK CIRCLE)

Between the styloid and

mastoid processes of
the temporal bone is the
stylomastoid foramen.

It is the termination of
the facial canal, and
transmits the facial
nerve and stylomastoid
artery.

(AFTER GRAY, 1918)

STYLOMASTOID FORAMEN AND FACIAL
CANAL
FACIAL NERVE
MASTOID PROCESS

RED CIRCLE
The course and connections of the facial nerve
in the temporal bone

(AFTER GRAY, 1918)

FACIAL NERVE
Mastiodian portion of digastric
muscle, stylomastoidian artery,
stylois process, mastoid
process, bony portion of
external auditory duct, are
important landmarks tracking
the facial nerve trunk and
division.
After Davis, forking facial nerve
trunk occurs two-thirds of the
distance gonion
temporomandibular joint, with
variations between individuals.
Changes in head and neck
position produce changes in
the parotid area in terms of
anatomical orientation of the
nerve.