What Is the Temporal Bone?

Temporal bone. Temporalbone is one of the pairs of brain and skull.

Temporal bone. Temporalbone is one of the pairs of brain and skull.

There are two skulls in the skull, one on each side. It is located on both sides of the skull and extends to the base of the skull. It participates in the sides that form the base of the skull and the cranial cavity, and is irregular in shape. The outer ear canal can be divided into three parts: temporal scales, drum and rock. The rock part can be divided into rock part, mastoid part, and styloid process, so the temporal bone can be composed of 5 parts: scale part, drum part, rock part, mastoid part, and styloid part. The temporal bone is embedded between the sphenoid bone, the parietal bone and the occipital bone, and participates in the formation of the middle cranial fossa and posterior cranial fossa. It is closely related to many important nerve vessels in the brain and the skull.

Chinese name

Temporal bone

Foreign name

temporal bone

Location

Located on both sides of the skull and extends to the base of the skull

Shape

irregular

Make up

Scalp, drum, mastoid

Features

Closely related to brain and intracranial neurovascular

Pinyin

Nie Gu

Temporal bone composition

It can be divided into three parts: rock part: pointed forward and inward, and bottom outwards; the front is facing the middle cranial fossa, the center is an arched bulge, the anterolateral is the tympanic cap, and the trigeminal nerve impression is at the apex; There is an inner ear door; there is a carotid artery outer mouth in the lower center, the jugular vein fossa behind it, and the styloid process behind the outer fossa. Temporal squamous area: It is located in front of and above the external ear, with the middle meningeal artery sulcus on the inside, and the condyles extending forward and below the outside and below. Drum: Surround the external ear canal from front, bottom and back.

Temporal bone

Temporal bone imaging

The advantages of the isotropic temporal bone scan and its clinical application value are: (1) it solves the problem that infants with congenital malformations (indispensable for multi-directional observation) cannot achieve other body scans [10]; (2) solves the problem Elderly people with head, neck, and nervous system disorders (hypertension, cervical spondylosis, cerebrovascular disease, etc.) cannot tolerate long-term overstretching and braking of the neck, so image scanning often has artifacts and even scan failures. ; (3) for the machine, due to the reduction in the number of exposures, the service life of the X-ray tube will be increased accordingly; (4) the amount of radiation received by the patient will be reduced accordingly; (5) the problem of setting the position angle is solved, in actual work, Due to the differences in individual development and the experience of operators, it is difficult to obtain a standard oblique sagittal plane. MPR can obtain the ideal slice plane by adjusting the angle, and realizes that one scan can be observed at any angle; (6) Solve The problem of metal artifacts when scanning dentures or silver clips in the coronal plane is eliminated.

Temporal Bone Related Diseases and Treatment

1. Temporal bone fractures are often associated with traumatic brain injuries. In the scope of otology, it can affect the outer ear, middle ear, inner ear and facial nerves. Some atypical fractures are concealed, and it is easy to miss the diagnosis. Deafness and other complications that seriously affect quality of life.

2. Early detection, early diagnosis, and early treatment are the key to the treatment of temporal bone fractures. The first symptoms of this disease are diverse, and cooperation with related departments such as neurosurgery, trauma orthopedics, oral and maxillofacial surgery should be strengthened. Early otoscopy and electrical audiometry are necessary to detect insignificant ear canal bleeding at an early stage, and to initially assess whether the bleeding site is from the external ear canal or the eardrum or tympanum. Patients with craniocerebral trauma who have a negative CT scan for the first time need attention, and positive lesions are often found on re-examination of CT. Some patients with temporal bone fractures without obvious craniocerebral trauma and scalp trauma only visit the otolaryngology department with sudden hearing loss as the main complaint. At this time, it is necessary to pay attention to the detailed inquiry of the history of external injuries. Impedance, cochlear electrogram, and ABR examinations to determine the extent and nature of hearing loss.

3. Conservative treatment is still the main treatment for temporal bone fractures complicated by cerebrospinal fluid ear and nose leaks, facial paralysis, and sensorineural hearing loss. In addition to early vital signs support in the emergency department, early application of corticosteroids is very necessary. Except for the reduction and fixation of concurrent depression fractures, most fracture patients are treated conservatively. The remaining patients with hearing loss, cerebrospinal fluid ear leak, facial paralysis, dizziness, tinnitus and other symptoms were effective with conservative treatments such as broad-spectrum antibiotics, nutritional nerves, improvement of microcirculation, dexamethasone, and hyperbaric oxygen chamber, and most of them recovered or showed significant improvement. The timing of surgical treatment for patients with traumatic facial palsy, such as the patient's condition and economic conditions, allows for careful selection of surgery when electrophysiological testing indicates that the nerve damage exceeds 90%. However, on the basis of fully informing patients of the risks and prognosis of surgery, the expectations of patients with facial paralysis should be appropriately reduced, so as to reduce the possibility of unnecessary medical disputes after surgery.

4. The four-class method based on the traditional three-class method of temporal bone fractures has advantages. Temporal CT is the most critical test for diagnosis and classification. Some cases of temporal bone fractures are simple temporal bone condylar branches, scales, and external auditory canal fractures. The traditional three-class classification cannot be used to classify the imaging diagnosis. Therefore, the four-class classification based on the traditional three-class classification proposed by the research group is adopted. That is, longitudinal fractures (including traditional longitudinal fractures and longitudinal fractures with scales, zygomatic arches, and external auditory canal fractures), transverse fractures (including traditional transverse fractures and transverse fractures with scales, sacral arch, and external auditory canal fractures), mixed fractures (while Complicated with the aforementioned two fractures), other types (especially fractures of simple squamous and / or metatarsal arch and / or external auditory canal).

5. Temporal bone fractures involve complex biomechanical mechanisms and molecular pathophysiology mechanisms of cranial nerve trauma and repair and regeneration after injury. The relevance of imaging diagnosis classification, surgical selection, drug treatment selection and prognosis is still controversial. .