TEMPORAL BONE

RADIOANATOMY
AND CONGENITAL
MALFORMATION
The temporal bone is situated on the sides and the
base of the cranium and lateral to the temporal lobe of
the cerebrum. The temporal bone is one of the most
important calvarial and skull base bones. The temporal
bone is very complex and consists of five parts:
1.Squamous
2. Mastoid
3.petrous.
4.Tympanic
5.styloid
The squamous part of the temporal bone (or squamous temporalis/squamous
temporal bone) is a very thin bone and forms the anterosuperior aspect of the
temporal bone.
Gross anatomy
The squamous temporal bone's outer convex surface provides attachment to
the temporalis muscle and forms a boundary of the temporal fossa. A curved line, the
supramastoid crest (or temporal line), runs posterosuperiorly across its posterior part
and provides attachment to the temporalis fascia.
The anterior aspect of the squamous temporal bone extends antero-inferiorly as well as
laterally to form the zygomatic process. The superior surface of the zygomatic process
provides attachment to the temporalis fascia, whereas its inferior surface is rough and
thick surface for the attachment of the masseter muscle.
The posterior root runs above the external auditory meatus and continues with the
supramastoid crest. The anterior root is directed medially and ends in the rounded,
cartilage-covered, articular eminence, which forms the anterior boundary of
the mandibular fossa.
Articulations
The squamous temporal bone articulates with various bones include:
superior border articulates with the parietal bone by temporoparietal suture
anteriorly it articulates with the zygomatic bone through the zygomatic process
anteroinferiorly it articulates with the greater wing of the sphenoid bone
The mastoid part of the temporal bone is its posterior component.
Gross anatomy
The mastoid part is normally pneumatized by the mastoid air cells and is perforated by
the mastoid foramen. The roof of the mastoid antrum, which separates the mastoid from
the cranial cavity, is called the tegmentum mastoideum, and is a posterior extension of
the tegmentum tympani.
The mastoid part has an outer rough surface that provides attachment
to occipitalis and auricularis posterior muscles. It continues inferiorly as the mastoid
process, which is a conical bony projection that provides attachment for a number of
muscles:
sternocleidomastoid
splenius capitis
the posterior belly of the digastric muscle
longissimus capitis muscles
On the medial aspect of the mastoid process is a deep groove, called the digastric
fossa, where the digastric muscles attach. Medial to this is the occipital groove, which is
traversed by the occipital artery. The sigmoid sulcus, which lodges part of the transverse
sinus, lies in the inner surface of the mastoid portion.
Articulations
Mastoid part of temporal bone articulates with the following bones
the superior border articulates with the mastoid angle of the parietal bone
the posterior border articulates with the inferior border of the occipital bone
anteriorly it is fused with the descending process of the squamous temporal bone
The petrous part of the temporal
bone (or more simply petrous temporal
bone, PTB) forms the part of skull
base between the sphenoid and occipital
bones.
Gross anatomy
The petrous temporal bone has a
pyramidal shape with an apex and a base
as well as three surfaces and angles:
apex (petrous apex)
direct medially; articulates with the
posterior aspect of the greater wing of
the sphenoid and basilar occiput
forms internal border of the carotid
canal and the posterolateral boundary
of the foramen lacerum
base
directed laterally and fuses with the
internal surface of squama temporalis
and mastoid
The petrous temporal bone has three surfaces - anterior, posterior and inferior:

the anterior surface forms the posterior part of the middle cranial fossa. It is
continuous with the inner surface of the squamous part united by the petrosquamous
suture. Near its center lies the arcuate eminence, which indicates the location of the
superior semicircular canal. Lateral to the arcuate eminence is a depression which
indicates the position of middle ear cavity. A shallow groove directed posterolaterally to
open into the hiatus of the facial canal. Lateral to this hiatus a smaller hiatus for
the lesser petrosal nerve. At the apex, the termination of the carotid canal is present.

the posterior surface forms the anterior part of posterior cranial fossa. It fuses with
the inner surface of the mastoid. Near the center of the posterior surface is the internal
acoustic meatus. Posteriorly to the internal acoustic meatus is a small slit, leading to the
canal of the vestibular aqueduct.

the inferior surface forms part of the exterior of the base of the skull. There are a
number of foramina including the inferior opening of the carotid canal and posteriorly
the jugular foramen and in between a small inferior tympanic canaliculus, through
which the tympanic branch of the glossopharyngeal nerve passes. The stylomastoid
foramen is situated on the inferior surface. It provides attachment to the levator veli
palatini and the cartilaginous portion of the Eustachian tube.
The petrous temporal bone has three angles:

the superior angle with an attachment to the tentorium cerebelli, its medial arm
lodges the trigeminal nerve and the superior petrosal sinus lodges in the groove of the
angle
the posterior angle which contains a sulcus that houses the inferior petrosal
sinus medially, and the jugular notch of the occipital bone forms the jugular
foramen laterally
the anterior angle whose medial half articulates with the spinous process of
the sphenoid and lateral half fuses with the squamous part at the petrosquamous suture.
The tympanic part of the temporal
bone is situated inferiorly to the squamous
part and anteriorly to the mastoid part.
The tympanic part surrounds the external
auditory meatus, forming the anterior wall,
floor and some of the posterior wall of the
bony external acoustic meatus. The lateral
border of the tympanic part gives the
attachment to the cartilaginous part of the
external acoustic meatus. Its anteroinferior
surface forms the posterior boundary of
the mandibular fossa. It fuses medially
with the petrous part and posteriorly with
the squamous and mastoid parts.
The styloid process (or styloid part of the squamous temporal
bone) is a slender pointed part of the temporal bone. It projects
anteroinferiorly from the inferior surface of the temporal bone.
It serves as an anchor point for several muscles associated with
the tongue and larynx:
styloglossus muscle
stylohyoid muscle
stylopharyngeus muscle
stylohyoid ligament
stylomandibular ligament
It should be noted that all of these structures, along with the styloid
process itself, develop from the second branchial arch and combined
form the styloid apparatus.
Morphological variants
type I: normal (less than 30 mm)
type II: elongated (more than 30 mm)
type III: pseudoarticulated
type IV: segmented
The temporal bones comprise the lateral skull base, forming portions of the
middle and posterior fossae. Each temporal bone is composed of five osseous
parts: the squamous, mastoid, petrous, tympanic, and styloid portions. Several
intrinsic channels, intrinsic fissures, and extrinsic sutures are often apparent on
CT images and can mimic fractures (pseudofractures). The major anatomic
landmarks of the temporal bones are depicted on axial and coronal CT images
Figure 1: Axial CT image shows: 1, mastoid antrum; 2, aditus ad antrum; 3,
epitympanum; 4, lateral semicircular canal; 5, vestibule; 6, labyrinthine
segment of the facial nerve; 7, IAC; 8, posterior semicircular canal.
Figure 2: Axial CT image shows: 1, mastoid air cells; 2, incus (short process); 3, incudomalleal joint; 4, malleus (head); 5, epitympanum (anterior
epitympanic recess); 6, basal turn of the cochlea; 7, middle turn of the cochlea; 8, otic capsule; 9, IAC; 10, modiolus; 11, vestibule.
Figure 3: Axial CT image shows: 1, stapes (head); 2, incus (long process); 3, malleus (neck); 4, tensor tympani; 5, carotid canal; 6, apical turn of the
cochlea; 7, middle turn of the cochlea; 8, basal turn of the cochlea; 9, interscalar septum; 10, round window niche; 11, vestibular aqueduct; 12, sinus
tympani; 13, stapedius; 14, pyramidal eminence; 15, mastoid portion of the facial nerve; 16, facial recess.
Figure 4: Coronal CT image shows: 1, EAC; 2, mastoid air cells; 3, tegmen mastoideum; 4, tegmen tympani; 5, tympanic segment of the facial nerve; 6,
labyrinthine segment of the facial nerve; 7, petrous apex; 8, basal turn of the cochlea; 9, interscalar septum; 10, middle turn of the cochlea; 11, carotid
canal; 12, tendon of the tensor tympani; 13, lateral process of the malleus; 14, lateral malleal ligament; 15, malleus (head).
Figure 5: Coronal CT image shows: 1, mastoid air cells; 2, tegmen mastoideum; 3, tegmen tympani; 4, IAC; 5, vestibule; 6, hypotympanum; 7,
mesotympanum; 8, epitympanum; 9, cochlear promontory; 10, tympanic membrane; 11, scutum; 12, Prussak space; 13, malleus (head); 14, stapes
(crus); 15, superior semicircular canal; 16, tympanic segment of the facial nerve; 17, oval window; 18, crista falciformis; 19, EAC.
The middle ear consists of the tympanic
cavity and the antrum.
The antrum is a large aircell superior and
posterior to the tympanic cavity and
connected to the tympanic cavity via the
aditus ad antrum.
The epitympanum or attic is the upper
portion of the tympanic cavity above the
tympanic membrane, and contains the head
of the malleus and the body of the incus.
The tympanic membrane, the malleus, incus
and stapes transfer soundwaves to the stapes
footplate, which is attached to the base of
Axial anatomy from inferior to superior
At the most inferior level we see the facial
nerve passing inferiorly to finally reach the
stylomastoid foramen (not shown in this
image).
The carotid artery is shown within the carotid
canal.
Tympanic membrane
The manubrium of the malleus (yellow
arrow) is connected to the tympanic
At this level we can see the manubrium of
the malleus (yellow arow) anterior to the
long process of the incus.
The round window is indicated by the blue
arrow.
The round window dissipates the pressure
generated by the fluid vibrations within the
cochlea and thus serves as a release valve.
Stapes
The base of the stapes rocks in and out
against the oval window.
The vibrations are transmitted via the
endolymph to the hair cells of the organ of
Corti of the cochlea.
Cochlea
Within the cochlea the movement of the
hair cells convert the sound-vibrations into
nerve impulses, that travel over the
cochlear nerve to the auditory cortex of the
brain, which interprets the impulses as
sound. .
The head of the malleus is seen anterior to
Tympanic segment of the facial nerve
In this image at the level of the internal
auditory canal, the tympanic segment of
the facial nerve is seen just medial and
parallel to the wall of the epitympanum.
The head of the malleus (yellow arrow) is
seen anterior to the head and the short
process of the incus.
Geniculate ganglion of the facial
nerve
At this level the aditus ad antrum is seen.
This is the connection between the
tympanic cavity and the antrum.
The labyrinthine segment of the facial
nerve coming from the internal auditory
canal angles sharply forward, nearly at
right angles to the long axis of the petrous
bone, to reach the geniculate ganglion.
At the ganglion the facial nerve makes a U-
turn (first genu of the facial nerve) to run
posteriorly as the tympanic segment along
Antrum
At this level the antrum is seen surrounded
by smaller mastoid aircells just lateral to
the superior semicircular canals .
The three semicircular canals lie
perpendicular to each other to sense
acceleration and deceleration movements
in each of the 3 spatial planes.
Static head position is sensed by the
vestibule, which contains the position hair
cells.
Different head positions produce different
gravity effects by small calcium carbonate
 CORONAL SECTION

The petrous bone is positioned in an

oblique orientation from posterolateral to
anteromedial.
As a result most structures will be
sectioned obliquely on coronal images.
The following coronal images go from
anterior to posterior.
First we will see the tympanic membrane
with the ossicles, followed by the cochlea,
antrum and semicircular canalls.
Finally the most posterior image will show
the point where the facial nerve exits the
temporal bone at the stylomastoid
foramen.
Scutum
The scutum (yellow arrow) is a sharp bony
spur formed by the lateral wall of the
tympanic cavity and the superior wall of the
external auditory canal.
It is usually the first bony structure to erode
as a result of a cholesteatoma, that is
formed by medial retraction of the pars
flaccida of the tympanic membrane into the
epitympanum.
If the retraction continues it will result in
ossicular destruction.
If the cholesteatoma passes posteriorly
through the aditus ad antrum into the
mastoid itself, erosion of the tegmen
mastoideum, with exposure of the dura and
erosion of the lateral semicircular canal
with deafness and vertigo, may result.
On the left the most anterior point of the
facial nerve is seen (white arrow).
At this point the nerve makes a U-turn.
It is named the genu or geniculum and
represents the geniculate ganglion.
The malleus is seen connected to the
tympanic membrane and to the incus.
On the coronal reconstruction on the left it
is clearly demonstated that the incus is
positioned posterolaterally to the malleolar
head.
The long crus of the incus subsequently
runs inferomedially to the stapes.
A coronal image slightly more posteriorly
will show the facial nerve twice.
The medial portion is the part that exits the
internal auditory canal and runs towards
the geniculate ganglion (medial white
arrow).
The lateral portion is the part that courses
in a posterior direction, coming from the
Facial nerve canal
The facial nerve is seen in the internal
auditory canal and entering the temporal
bone (medial white arrow).
The lateral white arrow represents the
tympanic segment of the facial nerve
running in the facial canal and curving
around the oval window niche.
At this point, the nerve runs in a horizontal
plane in a posterior direction superiorly to
the oval window .
The incus (orange arrow) is seen
connecting to the stapes (blue arrow).
Coronal scan showing the facial nerve
(white arrow) above the oval window and
below the lateral semicircular canal.
Antrum
The antrum is a large aircell superior and
posterior to the tympanic cavity and
connected to the tympanic cavity via the
aditus ad antrum.
It is surrounded by smaller mastoid
the facial nerve assumes a vertical position
to exit the petrous bone through the
stylomastoid foramen.
The tympanic cavity is the major portion of the middle ear and contains the ossicles of
the middle ear.
Medial wall
contains the oval and round window and the prominence of the tympanic segment of the
facial nerve.
Lateral wall
is mainly formed by the tympanic membrane. The scutum is the bony prominence at the
upper part or pars flaccidum of the tympanic membrane.
Roof
is called the tegmen and separates the upper part of the tympanic cavity or
epitympanum from the middle cranial fossa.
Posterior wall
forms the entrance to the mastoid and is called the aditus ad antrum.
Tympanic membrane
The tympanic membrane or eardrum is a
cone-shaped membrane that separates the
external ear from the middle ear.
The pars flaccida is the upper fragile part
that is associated with eustachian tube
dysfunction and cholesteatoma.
The pars tensa is larger and more rubust
and associated with perforations.
The handle or manubrium of the malleus is
connected to the central part of the
tympanic membrane, which is called the
umbo.
Here a patient with a cholesteatoma.
There is a soft tissue mass in the
epitympanum.
Notice the perforation of the tympanic
membrane (yellow arrow) and the erosion
of the lateral semicircular canal (red
arrow).
The scutum is blunted.
Scutum
This is usually the first bony structure to erode as a result of a cholesteatoma, that is
formed by medial retraction of the pars flaccida of the tympanic membrane into the
epitympanum.
If the retraction continues it will result in ossicular destruction.
If the cholesteatoma passes posteriorly through the aditus ad antrum into the
mastoid itself, erosion of the tegmen mastoideum, with exposure of the dura and
erosion of the lateral semicircular canal with deafness and vertigo, may result.
The antrum is a large aircell superior and
posterior to the tympanic cavity and
connected to the tympanic cavity via the
aditus ad antrum.
It is surrounded by smaller mastoid
aircells.
FACIAL NERVE
The labyrinthine segment of the facial nerve coming from the internal auditory canal
angles sharply forward, nearly at right angles to the long axis of the petrous bone, to
reach the geniculate ganglion.
At the ganglion the facial nerve makes a U-turn (first genu of the facial nerve) to run
posteriorly as the tympanic segment along the medial wall of the epitympanum.
THE OVAL AND ROUND WINDOW
The base of the stapes rocks in and out
against the membrane in the oval window.
The vibrations are transmitted from the
oval window via the endolymph to the hair
cells of the organ of Corti in the cochlea.
The round window dissipates the pressure
generated by the fluid vibrations within the
cochlea and thus serves as a release valve.