Basics of Oral and Maxillofacial Surgery

**3**

**Chapter 1**

Bone

**Abstract**

temporal bone

**1. Introduction**

Surgical Anatomy of the Temporal

Numerous neurological lesions and tumors of the paranasal sinuses and oral cavity may spread into the middle and posterior cranial fossae through the anatomical apertures. For the appropriate management of these pathologies, many extensive surgical approaches with a comprehensive overview of the anatomical landmarks are required from the maxillofacial surgery's point of view. The surgical significance lies in the fact that iatrogenic injury to the petrous segment of the temporal bone including the carotid artery, sigmoid sinus, and internal jugular vein, can lead to surgical morbidity and postoperative pseudoaneurysm, vasospasm, or carotid-cavernous fistula. To simplify understanding complex anatomy of the temporal bone, we aimed to review the surgical anatomy of the temporal bone focusing on the associations between the surface landmarks and inner structures. Also, breaking down an intricate bony structure into smaller parts by compartmental approach could ease a deep concentration and navigation. To identify the anatomic architecture of the temporal bone by using reference points, lines and compartments can be used to supplement anatomy knowledge of maxillofacial surgeons and may improve confidence by surgical trainees. Especially, this systematic method may provide an easier way to teach and learn surgical spatial structure

**Keywords:** maxillofacial surgery, segmentation, surface landmarks, surgical anatomy,

The temporal bone is a dense complex bone that constitutes the lower lateral aspect of the skull and has complex anatomy because of the three-dimensional relationships between neurovascular structures. The petrous portion of the temporal bone has a role as the partition between the middle and posterior cranial fossae. It articulates with the occipital bone (occipitomastoid suture) posteriorly, the parietal bone (squamous suture) superiorly, the sphenoid bone (sphenosquamosal suture) and the zygomatic bone (arcus zygomaticus) anteriorly, and the mandible (temporomandibular joint) inferiorly [1, 2]. It contains multiple intrinsic channels, along with the internal carotid artery (ICA), cranial nerves, and sigmoid sinus (SS), all within intricate spatial architecture. Owing to a complex web of foramina and neurovascular structures of the temporal bone, the lateral skull base is a technically difficult region for surgeons. Because the middle and inner ear structures of hearing and equilibrium are preserved in the temporal bone,

*Gülay Açar and Aynur Emine Çiçekcibaşı*

of the petrous pyramid in clinical applications.
