Temporal Bone Anatomy

Anatomy
•  Temporal bone
 – Squamous portion
 – Mastoid portion
 – Petrous portion
 –  Tympanic portion
 – Styloid process
 External auditory canal
• Approximately 2.5-3.5 cm long 6-9 mm wide
• Outer 1/3 : extension of the cartilage of the auricle
• Inner 2/3 : incomplete ring of the tympanic bone
• Lined by skin
  Tympanic membrane
• Separates the EAC from middle ear cavity
• Fibroelastic layer
 – Outer surface : covered by canal
c anal skin
 – Medial surface : by the middle ear
e ar mucosa
•  The circumference of the membrane
 –  Thickened and forms annulus
 – Open anterosuperiorly
• Pars flaccida
 –  Triangular segment, bordered by mallear fold
 – Devoid of fibroelastic layer
• Pars tensa
• Convex medially : umbo
 Middle ear
• Air-filled irregular space
• Boundary
 – Lateral : TM, lateral attic wall
 – Medial : capsule of the inner ear
 – Superior : tegmen tympani
 – Inferior : hypotympanic floor
•  Three portions
 – Mesotympanum
 – Epitympanum
 – Hypotympanum : covers the jugular bulb
 Middle ear
• Pyramidal eminence
 – In the posterior wall of of the mesotympanum
 – Conical bony protrusion
 – Stapedius m. & its tendon
• Facial recess
 – Lateral to the pyramidal eminence
 – Covers the upper portion of the mastoid segment of the
facial canal
• Sinus tympani
 – Medial to the pyramidal eminence
 – Posterior pocket of mesotympanum
 Tympanic membrane
 Middle ear
• Ossicles
• Malleus, incus, stapes
- In the attic, head of malleus articulates with the incus body
- Malleus handle extends inferiorly to the TM
-  The long process of the incus articulates with the head of 
stapes
- Ice-cream appearance
: head of malleus & incus body, short process
Ossicles
• Posterior tympanum
• Pyramidal eminance 를 기준으로 sup
와 inf,
• facial canal 을 중심으로 lat 과 med 로
구분
• Superolateral : facial sinus
• Inferolateral : lateral tympanic sinus
• Superomedial : posterior tympanic
sinus
• Ponticulus : pyramidal eminance 에서
promontory 로 이어지는 bony ridge
• Subiculum : styloid eminance 에서
round window niche 의 post. lip 으로
이어지는 bony ridge
 – 이사이에 가장 큰 sinus tympani 존재
  Tympanic Isthmus
•  Two openings between
mesotympanum and attic
 – Anterior isthmus
• Between tensor tympani tendon and the
stapes
 – Posterior isthmus
• Between the short process of the incus
i ncus and
the stapedial tendon and pyramidal
eminence
 Prussak’s space
• Prussak’s space
 – Laterally pars flaccida
 – Medially the neck of the malleus
 – Superiorly lateral malleal ligament
 – Inferiorly the lateral process of the malleus
 Facial nerve
1. Intracranial(Pontine) segment
- 23-24mm length
- from brain stem to the internal auditory canal
2. IAC(Meatal) segment
- 8-10mm length
- from the fundus of the IAC to the meatal foramen
- anterior superior part of IAC
3. Labyrinthine segment
- 3-5mm length
- from the meatal foramen to the geniculate ganglion
- branch: GSPN
 Facial nerve
4. Tympanic segment
- 8-12mm length
- from first genu to second genu
- inferior part of LSCC
- Superior part of oval window
5. Mastoid segment
- 10-15mm length
- from second genu to stylomastoid foramen
- chorda tympani
6. Extratemporal segment
- from the stylomastoid foramen to the the muscles of 
innervation
Facial nerve
Dimensions of the Facial Nerve
Common Site of FN Injury during Otologic
Surgery
1) Intracranial segment: Brainstem-CPA lesions
2) Mastoid segment: Mastoidectomy
3) Tympanic segment
- Stapedectomy
- Labyrinthectomy (medial side)
4) Extracranial segment
- Parotidectomy
 Facial nerve geniculate ganglion

Superior SCC

Common crus

Lateral
SCC
Vestibular aqueduct Posterior SCC
 Facial nerve tympanic segment

Cochlea

Lateral SCC

Internal auditory canal