CT Imaging of The Temporal Bone 2

Computed Tomographic Anatomy of
the Temporal Bone
Presented By:-
Dr.Yashveer Singh
Department of Radiodiagnosis
PUBLISHED
BY-
AJR
(1982)
Outline
• Temporal Bone Part

• External Ear/Auditory Canal(EAC)
Tympanic Membrane
• Middle Ear-Mastoid
Ossicles
Spaces
Walls
• Internal Ear
Internal Auditory Canal
Cochlea
Facial Nerve
• Temporal Bone CT
Axial
Coronal
• Reporting Checklist
• Temporal Bone trauma
The temporal bone is made
up of 5 parts:
• Squamous
• Mastoid
• Petrous
• Tympanic
• Styloid
Squamous Bone
• Squamous portion of temporal bone forms lateral

wall of middle cranial fossa and interfaces with
parietal bone superiorly, with zygomatic &
sphenoid anteriorly.
• Medial surface is grooved by a sulcus for middle
meningeal artery and lateral surface for middle
temporal artery.
Mastoid bone
• Mastoid portion of temporal

bone is the inferiorly
extending projection seen on
lateral surface.
• It is composed of squamous
portion laterally and petrous
portion medially separated by
petrosquamous (Korner’s
septum).
Petrous Part
• Petrous portion is pyramidal in shape

and is wedged in at the base of the
skull between thee sphenoid and
occipital bone. Directed medial ward,
forward and a little upward.
Styloid process
• The styloid process of the temporal

bone is a slender osseous projection
that points anteroinferiorly from the
inferior surface of the petrous part of
the temporal bone.
• 2.5 cm in length.
Human
Ear
External Auditory Canal (EAC)
EAC is ‘S shaped’ structure which

extends from pinna laterally to the
tympanic membrane medially.
Length of EAC-24mm
Lateral 1/3 is cartilaginous =8mm
Medial/Inner 2/3 is bony= 16mm
Tympanic Membrane
 Tympanic Membrane part

 Pars Flaccida (sharpnel’s Membrane)
 Pars Tensa
Middle Ear Anatomy
 Air-containing space
Communicates with the
nasopharynx via the eustachian
tube.
Normally sealed laterally by
TM.
 Function:
Transmission and amplification of
sound from TM to stapes
footplate.
Walls of Middle Ear (Tympanic) Cavity
Walls of Tympanic Cavity:
(Lateral Wall)
•Lateral Wall formed by tympanic

Membrane
•BonyLateral wall of attic is Scutum
•TM divide middle ear in to-
• Epitympanum/Attic
• Mesotympanum
• Hypotympanum
(Anterior Wall)
•Anterior Wall structures

(Mnemonics EAT)
• Tensor Tympani Muscle
• Pharyngotympanic
tube(Eustachian Tube)
• Internal Carotid Artery
Walls of Tympanic
Cavity: (Floor)
• Floor: Superior bulb of

Internal Jugular Vein
(Roof)
• Roof: Tegemen Tympani

• It is a thin plate of the petrous part
of the temporal bone that separates
the intracranial compartment and
middle ear.
Walls of Tympanic
Cavity: Medial
• Prominence of lateral Semicircular

Canal
• Facial Nerve : Enters from inner
ear-
Labyrinthine Segment
Tympanic segment
Vertical Segment
• Round Window
• Bulge of Cochlea
• Oval Window (Stapes attached)
Walls of Tympanic Cavity: Posterior
• Superiorly Aditus ad Antrum.

• Vertical Part of Facial Nerve
(Mastoid segment)
• Corda Tympani Nerve
• Pyramidal Eminenence
 Sinus Tympani(Medial Recess)
 Facial Recess(Lateral Recess)
Inside the Middle Ear:
Ossicular Chain
•Malleus: Epitympanum: Head

articulates with body of Incus (Ice
Cream Cone)
•Mesotympanum: Neck and Handle
• Incus:
 Epitympanum: Short process
 Mesotympanum: Long process (LPI)
articulates with head of Stapes
• Stapes:Head, neck, two crura
(anterior and posterior) and a footplate.
• Incudomalleal Joint
• Incudostapedial joint
ANATOMY: INNER EAR
• The SSC and PSC are both

arranged in vertical orientation
at right angles to each other.
• SSC is directed anterolaterally

at an angle of 45 to Mid-
Sagittal plane and PSC is
directed posterolaterally at a
corresponding angle.
• Lateral SCC does not lie in a

horizontal plane, its anterior
limb makes an angle of 30 to
the posterior limb.
VESTIBULE
LATERAL SEMICIRCULAR CANAL
ANATOMY: INNER EAR: COCHLEA
• 2.75 Turns
• Modiolus is the central bony axis.
• Spiral lamina - separates outer
scala vestibuli from inner scala
tympani.
• Interscalar septum, separates apical
and middle turn of cochlea.
ANATOMY: INNER EAR
•VESTIBULAR AQUEDUCT
• Carries endolymph from membranous

labyrinth to endolymphatic sac.
• Its width should not be more than 15mm
or adjacent PSC.
ANATOMY: INNER EAR
COCHLEAR AQUEDUCT
 Contains perilymph
 Communicates scala tympani and sub-
arachnoid space
Situated caudally
 Infected cerebrospinal fluid can enter
the inner ear: in patients with meningitis
and cause labyrinthitis ossificans.
ANATOMY: FACIAL
NERVE
• Labyrinthine
• Ist genu
• Tympanic -Horizontal
• 2nd genu
• Mastoid- Vertical
Axial Slice (Superior to Inferior)
A S
Axial View P Coronal

View
I
• The following slides are representative axial slices through the
normal temporal bone, proceeding inferiorly from the most superior
cut (through the superior semicircular canal).
Axial: Superior SCC
 Superior SCC:
 Perpendicular to long axis of temporal bone
 Superior petrosal sinus:
 Receives blood from cavernous sinus, drains to transverse sinus
Axial: Epitympanum
 Epitympanum: space above TM annulus (ring)

 What do the structures in the box resemble?
Ice cream cone!
Correspond to ossicles: malleus head, incus body
Axial: IAC And Vestibular system
 Internal auditory canal (IAC) FN SV

P
A
• Structures anterior to IAC are cochlear C IV
• Structures posterior to IAC are vestibular

Axial: Vestibular Aqueduct
 Vestibular aqueduct:
 Bony canal that passes to posterior fossa dura
 Opens lateral to IAM

 Transmits endolymphatic duct and 2 blood vessels into
blind sac (reservoir for excess endolymph)

 Common crus: union of superior and posterior SC ducts.
Axial: Tensor tympani canal
 Tensor tympani muscle:

 arises from cartilaginous and bony margins of eustachian tube
 inserts on handle of malleus
 Dampens ossicular chain
 Lateral SCC
 Stapes
Axial: Round Window
Promontor Promontor
y y
 Round window:
 Opening between middle and inner ear, associated with scala
tympani
 below oval window
 Promontory:
 Medial wall of tympanic cavity formed by basal turn of cochlea
Coronal Slice (Posterior to Anterior)
A S
Axial P Coronal
View View
I
The following slides are representative coronal slices through the
normal temporal bone, proceeding anteriorly from the most posterior
cut (through the semicircular canals).
Coronal: Semicircular Canal Relationship
90° angle between Lateral and Superior SCC

Coronal: Scutum
 Scutum: spur-shaped bony projection top of tympanic

membrane
 Often eroded by cholesteatoma
Coronal: Tympanic Membrane
Outline of Tympanic Membrane

Coronal: Prussak’s space
 Prussak’s space: anterior recess of TM, between neck

of malleus and pars flaccida of tympanic membrane
 Most common site of acquired attic cholesteatoma.
Coronal
 Observe:
 Snail like appearance of
Cochlea.
 Question: How can the facial nerve appear twice in
a single coronal slice?
 Answer: facial nerve turns at the anterior genu

(turn)!
REPORTING CHECKLIST
Soft-tissue involvement of Antrum, Middle Ear, Posterior tympanic space

Carotid canal, Jugular bulb
Lateral Semicircular Canal
Facial Canal
Mastoid Antrum - Pneumatization
Ossicular- Incus > Malleus > Stapes
Complications
☺️ Thank You

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CT Imaging of The Temporal Bone 2

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Computed Tomographic Anatomy of

the Temporal Bone

• Temporal Bone Part

• Squamous portion of temporal bone forms lateral

• Mastoid portion of temporal

• Petrous portion is pyramidal in shape

• The styloid process of the temporal

EAC is ‘S shaped’ structure which

 Tympanic Membrane part

•Lateral Wall formed by tympanic

•Anterior Wall structures

• Floor: Superior bulb of

• Roof: Tegemen Tympani

• Prominence of lateral Semicircular

• Superiorly Aditus ad Antrum.

•Malleus: Epitympanum: Head

• The SSC and PSC are both

• SSC is directed anterolaterally

• Lateral SCC does not lie in a

• Carries endolymph from membranous

Axial View P Coronal

 Epitympanum: space above TM annulus (ring)

 Internal auditory canal (IAC) FN SV

• Structures posterior to IAC are vestibular

 Opens lateral to IAM

blind sac (reservoir for excess endolymph)

 Tensor tympani muscle:

90° angle between Lateral and Superior SCC

 Scutum: spur-shaped bony projection top of tympanic

Outline of Tympanic Membrane

 Prussak’s space: anterior recess of TM, between neck

 Answer: facial nerve turns at the anterior genu

Soft-tissue involvement of Antrum, Middle Ear, Posterior tympanic space

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