Head and Neck Pathology

, Volume 12, Issue 3, pp 321–327 | Cite as

Anatomy and Surgical Approach of the Ear and Temporal Bone

  • Brandon IsaacsonEmail author
Special Issue: Ear


The temporal bone is one of the more complex structures at the skull base that houses the hearing and vestibular organs, numerous nerves, and vessels. A host of inflammatory and neoplastic processes can occur within the temporal bone that often necessitate permanent and frozen section pathologic examination. A number of simple to complex surgical procedures are used to manage temporal bone pathology. This chapter will provide a brief overview of normal temporal bone anatomy, common surgical approaches, normal histology, and indications for pathologic examination.


Temporal bone Ear Tympanoplasty Mastoidectomy Petrous bone Paraganglioma Skull base 


Compliance with Ethical Standards

Conflict of interest

Brandon Isaacson, MD, FACS declares that he has the following conflicts of interest. Advisory Boards: Med-el, Advanced Bionics. Consultant: Karl Storz Endoscopy, Olympus, Medtronic, Stryker.

Research Involving Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Barrow HN, Levenson MJ. Necrotizing ‘malignant’ external otitis caused by Staphylococcus epidermidis. Arch Otolaryngol Head Neck Surg. 1992;118(1):94–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Kwong Y, Yu D, Shah J. Fracture mimics on temporal bone CT: a guide for the radiologist. Am J Roentgenol. 2012;199(2):428–34.CrossRefGoogle Scholar
  3. 3.
    Lim DJ. Structure and function of the tympanic membrane: a review. Acta Otorhinolaryngol Belg. 1995;49(2):101–15.PubMedGoogle Scholar
  4. 4.
    Tarabichi M, Marchioni D, Presutti L, Nogueira JF, Pothier D. Endoscopic transcanal ear anatomy and dissection. Otolaryngol Clin N Am. 2013;46(2):131–54.CrossRefGoogle Scholar
  5. 5.
    Marchioni D, Alicandri-Ciufelli M, Molteni G, Artioli FL, Genovese E, Presutti L. Selective epitympanic dysventilation syndrome. Laryngoscope 2010;120(5):1028–33.PubMedGoogle Scholar
  6. 6.
    Wick CC, Hansen AR, Kutz JW Jr, Isaacson B. Endoscopic infracochlear approach for drainage of petrous apex cholesterol granulomas: a case series. Otol Neurotol. 2017;38(6):876–81.CrossRefPubMedGoogle Scholar
  7. 7.
    Jufas N, Marchioni D, Tarabichi M, Patel N. Endoscopic anatomy of the protympanum. Otolaryngol Clin N Am. 2016;49(5):1107–19.CrossRefGoogle Scholar
  8. 8.
    Isaacson B, Kutz JW, Roland PS. Lesions of the petrous apex: diagnosis and management. Otolaryngol Clin N Am. 2007;40(3):479–519.CrossRefGoogle Scholar
  9. 9.
    Anzola JF, Nogueira JF. Endoscopic techniques in tympanoplasty. Otolaryngol Clin N Am. 2016;49(5):1253–64.CrossRefGoogle Scholar
  10. 10.
    Wick CC, Arnaoutakis D, Kaul VF, Isaacson B. Endoscopic lateral cartilage graft tympanoplasty. Otolaryngol Head Neck Surg. 2017;157(4):683–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Yawn RJ, Hunter JB, O’Connell BP, et al. Audiometric outcomes following endoscopic ossicular chain reconstruction. Otol Neurotol. 2017;38(9):1296–300.CrossRefPubMedGoogle Scholar
  12. 12.
    Isaacson B, Hunter JB, Rivas A. Endoscopic stapes surgery. Otolaryngol Clin N Am. 2018;15:415–28.CrossRefGoogle Scholar
  13. 13.
    Kircher ML, Thottam PJ, Bojrab DI, Babu SC. Utility and cost analysis of cholesteatoma histopathologic evaluation. Laryngoscope 2014;124(2):538–40.CrossRefPubMedGoogle Scholar
  14. 14.
    Ferlito A. A review of the definition, terminology and pathology of aural cholesteatoma. J Laryngol Otol. 1993;107(6):483–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Killeen DE, Wick CC, Hunter JB, et al. Endoscopic management of middle ear paragangliomas: a case series. Otol Neurotol. 2017;38(3):408–15.CrossRefPubMedGoogle Scholar
  16. 16.
    Wick CC, Manzoor NF, Semaan MT, Megerian CA. Endolymphatic sac tumors. Otolaryngol Clin N Am. 2015;48(2):317–30.CrossRefGoogle Scholar
  17. 17.
    Sozen E, Ucal YO, Kabukcuoglu F, Celebi I, Dadas B. An incidental middle-ear mass: Jacobson’s nerve schwannoma. Otol Neurotol. 2012;33(5):e37–8.CrossRefPubMedGoogle Scholar
  18. 18.
    McRackan TR, Wilkinson EP, Rivas A. Primary tumors of the facial nerve. Otolaryngol Clin N Am. 2015;48(3):491–500.CrossRefGoogle Scholar
  19. 19.
    Goycoolea MV. Mastoid and tympanomastoid procedures in otitis media: classic mastoidectomy (simple, modified, and radical) and current adaptations; open-cavity, closed-cavity, and intact-bridge tympanomastoidectomy. Otolaryngol Clin N Am. 1999;32(3):513–23.CrossRefGoogle Scholar
  20. 20.
    Vercruysse JP, van Dinther JJ, De Foer B, et al. Long-term results of troublesome CWD cavity reconstruction by mastoid and epitympanic bony obliteration (CWR-BOT) in adults. Otol Neurotol. 2016;37(6):698–703.CrossRefPubMedGoogle Scholar
  21. 21.
    Gidley PW. Managing malignancies of the external auditory canal. Expert Rev Anticancer Ther. 2009;9(9):1277–82.CrossRefPubMedGoogle Scholar
  22. 22.
    Breen JT, Roberts DB, Gidley PW. Basal cell carcinoma of the temporal bone and external auditory canal. Laryngoscope 2017. Scholar
  23. 23.
    Carlson ML, O’Connell BP, Breen JT, et al. Petroclival chondrosarcoma: a multicenter review of 55 cases and new staging system. Otol Neurotol. 2016;37(7):940–50.CrossRefPubMedGoogle Scholar
  24. 24.
    Blyth CC, Gomes L, Sorrell TC, da Cruz M, Sud A, Chen SC. Skull-base osteomyelitis: fungal vs. bacterial infection. Clin Microbiol Infect. 2011;17(2):306–11.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology – HNSUT – Southwestern Medical CenterDallasUSA

Personalised recommendations