5a. 4. The Temporal Bone

(Os Temporale)

The temporal bones are situated at the sides and base of the skull. Each consists of five parts, viz., the squama, the petrous, mastoid, and tympanic parts, and the styloid process. 1 The Squama (squama temporalis).—The squama forms the anterior and upper part of the bone, and is scale-like, thin, and translucent. 2

FIG. 137– Left temporal bone. Outer surface. (See enlarged image) Surfaces.—Its outer surface (Fig. 137) is smooth and convex; it affords attachment to the Temporalis muscle, and forms part of the temporal fossa; on its hinder part is a vertical groove for the middle temporal artery. A curved line, the temporal line, or supramastoid crest, runs backward and upward across its posterior part; it serves for the attachment of the temporal fascia, and limits the origin of the Temporalis muscle. The boundary between the squama and the mastoid portion of the bone, as indicated by traces of the original suture, lies about 1 cm. below this line. Projecting from the lower part of the squama is a long, arched process, the zygomatic process. This process is at first directed lateralward, its two surfaces looking upward and downward; it then appears as if twisted inward upon itself, and runs forward, its surfaces now looking medialward and lateralward. The superior border is long, thin, and sharp, and serves for the attachment of the temporal fascia; the inferior, short, thick, and arched, has attached to it some fibers of the Masseter. The lateral surface is convex and subcutaneous; the medial is concave, and affords attachment to the Masseter. The anterior end is deeply serrated and articulates with the zygomatic bone. The posterior end is connected to the squama by two roots, the anterior and posterior roots. The posterior root, a prolongation of the upper border, is strongly marked; it runs backward above the external acoustic meatus, and is continuous with the temporal line. The anterior root, continuous with the lower border, is short but broad and strong; it is directed medialward and ends in a rounded eminence, the articular tubercle (eminentia articularis). This tubercle forms the front boundary of the mandibular fossa, and in the fresh state is covered with cartilage. In front of the articular tubercle is a small triangular area which assists in forming the infratemporal fossa; this area is separated from the outer surface of the squama by a ridge which is continuous behind with the anterior root of the zygomatic process, and in front, in the articulated skull, with the infratemporal crest on the great wing of the sphenoid. Between the posterior wall of the external acoustic meatus and the posterior root of the zygomatic process is the area called the suprameatal triangle (Macewen), or mastoid fossa, through which an instrument may be pushed into the tympanic antrum. At the junction of the anterior root with the zygomatic process is a projection for the attachment of the temporomandibular ligament; and behind the anterior root is an oval depression, forming part of the mandibular fossa, for the reception of the condyle of the mandible. The mandibular fossa (glenoid fossa) is bounded, in front, by the articular tubercle; behind, by the tympanic part of the bone, which separates it from the external acoustic meatus; it is divided into two parts by a narrow slit, the petrotympanic fissure (Glaserian fissure). The anterior part, formed by the squama, is smooth, covered in the fresh state with cartilage, and articulates with the condyle of the mandible. Behind this part of the fossa is a small conical eminence; this is the representative of a prominent tubercle which, in some mammals, descends behind the condyle of the mandible, and prevents its backward displacement. The posterior part of the mandibular fossa, formed by the tympanic part of the bone, is non-articular, and sometimes lodges a portion of the parotid gland. The petrotympanic fissure leads into the middle ear or tympanic cavity; it lodges the anterior process of the malleus, and transmits the tympanic branch of the internal maxillary artery. The chorda tympani nerve passes through a canal (canal of Huguier), separated from the anterior edge of the petrotympanic fissure by a thin scale of bone and situated on the lateral side of the auditory tube, in the retiring angle between the squama and the petrous portion of the temporal. 3

FIG. 138– Left temporal bone. Inner surface. (See enlarged image) The internal surface of the squama (Fig. 138) is concave; it presents depressions corresponding to the convolutions of the temporal lobe of the brain, and grooves for the branches of the middle meningeal vessels. 4 Borders.—The superior border is thin, and bevelled at the expense of the internal table, so as to overlap the squamous border of the parietal bone, forming with it the squamosal suture. Posteriorly, the superior border forms an angle, the parietal notch, with the mastoid portion of the bone. The antero-inferior border is thick, serrated, and bevelled at the expense of the inner table above and of the outer below, for articulation with the great wing of the sphenoid. 5 Mastoid Portion (pars mastoidea).—The mastoid portion forms the posterior part of the bone. 6

FIG. 139– Coronal section of right temporal bone. (See enlarged image) Surfaces.—Its outer surface (Fig. 137) is rough, and gives attachment to the Occipitalis and Auricularis posterior. 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. On the medial side of the process is a deep groove, the mastoid notch (digastric fossa), for the attachment of the Digastricus; medial to this is a shallow furrow, the occipital groove, which lodges the occipital artery. 7 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. 8 Borders.—The superior border of the mastoid portion is broad and serrated, for articulation with the mastoid angle of the parietal. 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. 9 A section of the mastoid process (Fig. 139) 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. 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. 10

Petrous Portion (pars petrosa [pyramis]).—The petrous portion or pyramid is pyramidal and is wedged in at the base of the skull between the sphenoid and occipital. Directed medialward, forward, and a little upward, it presents for examination a base, an apex, three surfaces, and three angles, and contains, in its interior, the essential parts of the organ of hearing. 11 Base.—The base is fused with the internal surfaces of the squama and mastoid portion. 12 Apex.—The apex, rough and uneven, is received into the angular interval between the posterior border of the great wing of the sphenoid and the basilar part of the occipital; it presents the anterior or internal orifice of the carotid canal, and forms the postero-lateral boundary of the foramen lacerum. 13 Surfaces.—The anterior surface forms the posterior part of the middle fossa of the base of the skull, and is continuous with the inner surface of the squamous portion, to which it is united by the petrosquamous suture, remains of which are distinct even at a late period of life. It is marked by depressions for the convolutions of the brain, and presents six points for examination: (1) near the center, an eminence (eminentia arcuata) which indicates the situation of the superior semicircular canal; (2) in front of and a little lateral to this eminence, a depression indicating the position of the tympanic cavity: here the layer of bone which separates the tympanic from the cranial cavity is extremely thin, and is known as the tegmen tympani; (3) a shallow groove, sometimes double, leading lateralward and backward to an oblique opening, the hiatus of the facial canal, for the passage of the greater superficial petrosal nerve and the petrosal branch of the middle meningeal artery; (4) lateral to the hiatus, a smaller opening, occasionally seen, for the passage of the lesser superficial petrosal nerve; (5) near the apex of the bone, the termination of the carotid canal, the wall of which in this situation is deficient in front; (6) above this canal the shallow trigeminal impression for the reception of the semilunar ganglion. 14 The posterior surface (Fig. 138) forms the front part of the posterior fossa of the base of the skull, and is continuous with the inner surface of the mastoid portion. Near the center is a large orifice, the internal acoustic meatus, the size of which varies considerably; its margins are smooth and rounded, and it leads into a short canal, about 1 cm. in length, which runs lateralward. It transmits the facial and acoustic nerves and the internal auditory branch of the basilar artery. The lateral end of the canal is closed by a vertical plate, which is divided by a horizontal crest, the crista falciformis, into two unequal portions (Fig. 140). Each portion is further subdivided by a vertical ridge into an anterior and a posterior part. In the portion beneath the crista falciformis are three sets of foramina; one group, just below the posterior part of the crest, situated in the area cribrosa media, consists of several small openings for the nerves to the saccule; below and behind this area is the foramen singulare, or opening for the nerve to the posterior semicircular duct; in front of and below the first is the tractus spiralis foraminosus, consisting of a number of small spirally arranged openings, which encircle the canalis centralis cochleæ; these openings together with this central canal transmit the nerves to the cochlea. The portion above the crista falciformis presents behind, the area cribrosa superior, pierced by a series of small openings, for the passage of the nerves to the utricle and the superior and lateral semicircular ducts, and, in front, the area facians, with one large opening, the commencement of the canal for the facial nerve (aquæductus Fallopii). Behind the internal acoustic meatus is a small slit almost hidden by a thin plate of bone, leading to a canal, the aquæductus vestibuli, which transmits the ductus endolymphaticus together with a small artery and vein. Above and between these two openings is an irregular depression which lodges a process of the dura mater and transmits a small vein; in the infant this depression is represented by a large fossa, the subarcuate fossa, which extends backward as a blind tunnel under the superior semicircular canal. 15

FIG. 140– Diagrammatic view of the fundus of the right internal acoustic meatus. (Testut.) 1. Crista falciformis. 2. Area facialis, with (2’) internal opening of the facial canal. 3. Ridge separating the area facialis from the area cribrosa superior. 4. Area cribrosa superior, with (4’) openings for nerve filaments. 5. Anterior inferior cribriform area, with (5’) the tractus spiralis foraminosus, and (5’’) the canalis centralis of the cochlea. 6. Ridge separating the tractus spiralis foraminosus from the area cribrosa media. 7. Area cribrosa media, with (7’) orifices for nerves to saccule. 8. Foramen singulare. (See enlarged image) The inferior surface (Fig. 141) is rough and irregular, and forms part of the exterior of the base of the skull. It presents eleven points for examination: (1) near the apex is a rough surface, quadrilateral in form, which serves partly for the attachment of the Levator veli palatini and the cartilaginous portion of the auditory tube, and partly for connection with the basilar part of the occipital bone through the intervention of some dense fibrous tissue; (2) behind this is the large circular aperture of the carotid canal, which ascends at first vertically, and then, making a bend, runs horizontally forward and medialward; it transmits into the cranium the internal carotid artery, and the carotid plexus of nerves; (3) medial to the opening for the carotid canal and close to its posterior border, in front of the jugular fossa, is a triangular depression; at the apex of this is a small opening, the aquæductus cochleæ, which lodges a tubular prolongation of the dura mater establishing a communication between the perilymphatic space and the subarachnoid space, and transmits a vein from the cochlea to join the internal jugular; (4) behind these openings is a deep depression, the jugular fossa, of variable depth and size in different skulls; it lodges the bulb of the internal jugular vein; (5) in the bony ridge dividing the carotid canal from the jugular fossa is the small inferior tympanic canaliculus for the passage of the tympanic branch of the glossopharyngeal nerve; (6) in the lateral part of the jugular fossa is the mastoid canaliculus for the entrance of the auricular branch of the vagus nerve; (7) behind the jugular fossa is a quadrilateral area, the jugular surface, covered with cartilage in the fresh state, and articulating with the jugular process of the occipital bone; (8) extending backward from the carotid canal is the vaginal process, a sheath-like plate of bone, which divides behind into two laminæ; the lateral lamina is continuous with the tympanic part of the bone, the medial with the lateral margin of the jugular surface; (9) between these laminæ is the styloid process, a sharp spine, about 2.5 cm. in length; (10) between the styloid and mastoid processes is the stylomastoid foramen; it is the termination of the facial canal, and transmits the facial nerve and stylomastoid artery; (11) situated between the tympanic portion and the mastoid process is the tympanomastoid fissure, for the exit of the auricular branch of the vagus nerve. 16

FIG. 141– Left temporal bone. Inferior surface. (See enlarged image) Angles.—The superior angle, the longest, is grooved for the superior petrosal sinus, and gives attachment to the tentorium cerebelli; at its medial extremity is a notch, in which the trigeminal nerve lies. The posterior angle is intermediate in length between the superior and the anterior. Its medial half is marked by a sulcus, which forms, with a corresponding sulcus on the occipital bone, the channel for the inferior petrosal sinus. Its lateral half presents an excavation—the jugular fossa—which, with the jugular notch on the occipital, forms the jugular foramen; an eminence occasionally projects from the center of the fossa, and divides the foramen into two. The anterior angle is divided into two parts—a lateral joined to the squama by a suture (petrosquamous), the remains of which are more or less distinct; a medial, free, which articulates with the spinous process of the sphenoid. 17 At the angle of junction of the petrous part and the squama are two canals, one above the other, and separated by a thin plate of bone, the septum canalis musculotubarii (processus cochleariformis); both canals lead into the tympanic cavity. The upper one (semicanalis m. tensoris tympani) transmits the Tensor tympani, the lower one (semicanalis tubæ auditivæ) forms the bony part of the auditory tube. 18 The tympanic cavity, auditory ossicles, and internal ear, are described with the organ of hearing. 19 Tympanic Part (pars tympanica).—The tympanic part is a curved plate of bone lying below the squama and in front of the mastoid process. 20 Surfaces.—Its postero-superior surface is concave, and forms the anterior wall, the floor, and part of the posterior wall of the bony external acoustic meatus. Medially, it presents a narrow furrow, the tympanic sulcus, for the attachment of the tympanic membrane. Its antero-inferior surface is quadrilateral and slightly concave; it constitutes the posterior boundary of the mandibular fossa, and is in contact with the retromandibular part of the parotid gland. 21 Borders.—Its lateral border is free and rough, and gives attachment to the cartilaginous part of the external acoustic meatus. Internally, the tympanic part is fused with the petrous portion, and appears in the retreating angle between it and the squama, where it lies below and lateral to the orifice of the auditory tube. Posteriorly, it blends with the squama and mastoid part, and forms the anterior boundary of the tympanomastoid fissure. Its upper border fuses laterally with the back of the postglenoid process, while medially it bounds the petrotympanic fissure. The medial part of the lower border is thin and sharp; its lateral part splits to enclose the root of the styloid process, and is therefore named the vaginal process. The central portion of the tympanic part is thin, and in a considerable percentage of skulls is perforated by a hole, the foramen of Huschke. 22 The external acoustic meatus is nearly 2 cm. long and is directed inward and slightly forward: at the same time it forms a slight curve, so that the floor of the canal is convex upward. In sagittal section it presents an oval or elliptical shape with the long axis directed downward and slightly backward. Its anterior wall and floor and the lower part of its posterior wall are formed by the tympanic part; the roof and upper part of the posterior wall by the squama. Its inner end is closed, in the recent state, by the tympanic membrane; the upper limit of its outer orifice is formed by the posterior root of the zygomatic process, immediately below which there is sometimes seen a small spine, the suprameatal spine, situated at the upper and posterior part of the orifice. 23 Styloid Procéss (processus styloideus).—The styloid process is slender, pointed, and of varying length; it projects downward and forward, from the under surface of the temporal bone. Its proximal part (tympanohyal) is ensheathed by the vaginal process of the tympanic portion, while its distal part (stylohyal) gives attachment to the stylohyoid and stylomandibular ligaments, and to the Styloglossus, Stylohyoideus, and Stylopharyngeus muscles. The stylohyoid ligament extends from the apex of the process to the lesser cornu of the hyoid bone, and in some instances is partially, in others completely, ossified. 24 Structure.—The structure of the squama is like that of the other cranial bones: the mastoid portion is spongy, and the petrous portion dense and hard. 25

FIG. 142– The three principal parts of the tempora bone at birth. 1. Outer surface of petromastoid part. 2. Outer surface of tympanic ring. 3. Inner surface of squama. (See enlarged image)

FIG. 143– Temporal bone at birth. Outer aspect. (See enlarged image)

FIG. 144– Temporal bone at birth. Inner aspect. (See enlarged image) Ossification.—The temporal bone is ossified from eight centers, exclusive of those for the internal ear and the tympanic ossicles, viz., one for the squama including the zygomatic process, one for the tympanic part, four for the petrous and mastoid parts, and two for the styloid process. Just before the close of fetal life (Fig. 142) the temporal bone consists of three principal parts: 1. The squama is ossified in membrane from a single nucleus, which appears near the root of the zygomatic process about the second month. 2. The petromastoid part is developed from four centers, which make their appearance in the cartilaginous ear capsule about the fifth or sixth month. One (proötic) appears in the neighborhood of the eminentia arcuata, spreads in front and above the internal acoustic meatus and extends to the apex of the bone; it forms part of the cochlea, vestibule, superior semicircular canal, and medial wall of the tympanic cavity. A second (opisthotic) appears at the promontory on the medial wall of the tympanic cavity and surrounds the fenestra cochleæ; it forms the floor of the tympanic cavity and vestibule, surrounds the carotid canal, invests the lateral and lower part of the cochlea, and spreads medially below the internal acoustic meatus. A third (pterotic) roofs in the tympanic cavity and antrum; while the fourth (epiotic) appears near the posterior semicircular canal and extends to form the mastoid process (Vrolik). 3. The tympanic ring is an incomplete circle, in the concavity of which is a groove, the tympanic sulcus, for the attachment of the circumference of the tympanic membrane. This ring expands to form the tympanic part, and is ossified in membrane from a single center which appears about the third month. The styloid process is developed from the proximal part of the cartilage of the second branchial or hyoid arch by two centers: one for the proximal part, the tympanohyal, appears before birth; the other, comprising the rest of the process, is named the stylohyal, and does not appear until after birth. The tympanic ring unites with the squama shortly before birth; the petromastoid part and squama join during the first year, and the tympanohyal portion of the styloid process about the same time (Figs. 143, 144). The stylohyal does not unite with the rest of the bone until after puberty, and in some skulls never at all. 26 The chief subsequent changes in the temporal bone apart from increase in size are: (1) The tympanic ring extends outward and backward to form the tympanic part. This extension does not, however, take place at an equal rate all around the circumference of the ring, but occurs most rapidly on its anterior and posterior portions, and these outgrowths meet and blend, and thus, for a time, there exists in the floor of the meatus a foramen, the foramen of Huschke; this foramen is usually closed about the fifth year, but may persist throughout life. (2) The mandibular fossa is at first extremely shallow, and looks lateralward as well as downward; it becomes deeper and is ultimately directed downward. Its change in direction is accounted for as follows. The part of the squama which forms the fossa lies at first below the level of the zygomatic process. As, however, the base of the skull increases in width, this lower part of the squama is directed horizontally inward to contribute to the middle fossa of the skull, and its surfaces therefore come to look upward and downward; the attached portion of the zygomatic process also becomes everted, and projects like a shelf at right angles to the squama. (3) The mastoid portion is at first quite flat, and the stylomastoid foramen and rudimentary styloid process lie immediately behind the tympanic ring. With the development of the air cells the outer part of the mastoid portion grows downward and forward to form the mastoid process, and the styloid process and stylomastoid foramen now come to lie on the under surface. The descent of the foramen is necessarily accompanied by a corresponding lengthening of the facial canal. (4) The downward and forward growth of the mastoid process also pushes forward the tympanic part, so that the portion of it which formed the original floor of the meatus and contained the foramen of Huschke is ultimately found in the anterior wall. (5) The fossa subarcuata becomes filled up and almost obliterated. 27 Articulations.—The temporal articulates with five bones: occipital, parietal, sphenoid, mandible and zygomatic. 28

Contents -SUBJECT INDEX -BIBLIOGRAPHIC RECORD -ILLUSTRATION INDEX