8/14/2023 0 Comments Basilar fracture symptomsThis important part of the temporal bone encloses the middle and internal ear structures, along with parts of the facial nerve. It is not visible from a lateral view of the temporal bone. The petrous portion of the temporal bone is pyramidal in shape and wedged in at the base of the skull between the sphenoid and occipital bones. The mastoid process provides the attachment for the sternocleidomastoid (SCM) muscle, which gives the neck much of its mobility. The mastoid portion forms the posterior border of the temporal bone and is highly pneumatized in most individuals, with a communicating honeycomb in its interior known as mastoid cells (Fig. The styloid process arises inferior to the tympanic part and gives attachment to the stylohyoid and stylomandibular ligaments, and to the styloglossus and stylopharyngeus muscles. The tympanic portion of the temporal bone provides the remainder of the external acoustic meatus leading to and providing support for the tympanic membrane. The tympanic portion lines the external auditory meatus and the petrous portion is an interior structure and is not visible from a lateral view. The squamous, styloid, and mastoid portions are labeled. The squamous part also contributes to the roof of the external acoustic meatus.ĭiagram of the left temporal bone from a lateral view. The zygomatic arch divides the lateral surface of the head into two anatomic regions, the temporal fossa and the infratemporal fossa, and is also the site of attachment for the masseter muscle, one of the principal muscles of mastication. The zygomatic process arises from the squamous part, connecting the temporal bone to the zygomatic bone of the face through the zygomatic arch, as well as providing the superior articulation of the temporomandibular joint (TMJ). The squamous portion lies superior and anterior in relation to the remainder of the temporal bone and comprises much of the lateral wall of the middle cranial fossa. Anterior view (A), right lateral view (B), inferior view (C), and interior view of the skull base (D).Įach temporal bone is divided into five components: squamous, tympanic, styloid, mastoid, and petrous (Fig. Pediatric temporal bone trauma will be addressed separately, as presentation, treatment, and prognosis differ in this population compared with adults.ĭiagram of the paired temporal bones (shaded) in relation to the human skull. A brief description of the anatomy and function of the temporal bone will be presented, followed by a discussion of current guidelines in diagnosing and treating injuries to this structure. Complications can include intracranial hemorrhage, cerebral contusion, meningitis, hearing loss, and facial paralysis, all of which may result in death or permanent deficits. This article will focus on the diagnosis and treatment of temporal bone trauma, as these injuries can have drastic consequences if they are not recognized and treated promptly and effectively. Iatrogenic trauma to temporal bone structures can also occur, and is usually the result of inadvertent surgical injury to the internal ear or facial nerve. Because the temporal bone encloses the middle and internal ear, these structures can be damaged by penetrating or concussive trauma to the tympanic membrane through the external acoustic meatus without temporal bone fracture. Motor vehicle accidents are the most common cause, with falls and gunshot wounds contributing to a lesser extent. Temporal bone trauma is usually the result of blunt head injury and patients commonly suffer from multiple other body injuries. Children generally recover from temporal bone trauma with fewer complications than adults and experience a markedly lower incidence of facial nerve paralysis. Conductive hearing loss can be corrected surgically as an elective procedure, while sensorineural hearing loss carries a poor prognosis, regardless of management approach. Patients with declining facial nerve function are candidates for early surgical intervention. Emergent intervention is required in situations involving herniation of the brain into the middle ear cavity or hemorrhage of the intratemporal carotid artery. Diagnosis relies primarily on physical signs and symptoms as well as radiographic imaging. To prevent these complications, diagnosis followed by appropriate medical and surgical management is critical. Complications can include intracranial hemorrhage, cerebral contusion, CSF leak and meningitis, hearing loss, vertigo, and facial paralysis. Trauma is usually the result of blunt head injury and can result in damage to the brain and meninges, the middle and internal ear, and the facial nerve. The temporal bones are paired structures located on the lateral aspects of the skull and contribute to the skull base.
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