Temporal Bone Overview

Summary Thoughts: Temporal Bone

The temporal bone (T-bone) is one of the most complex and intriguing areas of the head and neck. Understanding normal anatomy is key to accurate T-bone image interpretation. Incorporating the otologic findings of a middle ear mass also helps the clinician to arrive at a correct preoperative diagnosis. If the clinical question is conductive hearing loss (CHL), an abnormality on CT is almost always present and should be extensively searched for, especially in children.

Cholesteatoma is a very common clinical concern in most otolaryngology practices. The following questions should be addressed in a patient with a cholesteatoma: (1) Is the tegmen tympani intact? (2) Is there potential for a fistula into the membranous labyrinth? (3) Is the facial nerve canal adjacent to or eroded by the cholesteatoma? (4) Is there tissue in the sinus tympani? (5) What is the relationship of the mass to the ossicles? Where is the location of the sigmoid sinus? How contracted is the mastoid cavity?