Although it is a single bone, the temporal bone is complex enough to have numerous dedicated textbooks. I know of no other single region, much less bone, that has so many clinically important small structures or spaces that are identifiable on cross-sectional imaging. Add to this the traversing vessels, nerves, and special sensory organs for hearing and balance and it certainly vies for the most complex anatomic area assessed on imaging. Although the essentials here only scratch the surface, these concepts go a long way towards understanding most the critical anatomy relevant for most clinical questions.

The 5 major components of the temporal bone include the squamous, mastoid, tympanic, petrous, and styloid process. Of these, the tympanic segment in particular contains many small structures and spaces that the radiologist should know.

Given orientation, special oblique views may be useful. Also, axial and coronal....

CN VII and VIII, ossicles, otic capsule.........

Canals, ossicles, IAC, jugular veins, carotids,

Fractures, Cranial nerves, hearing, positional sense. Although intricate, numerous key areas of anatomy that are susceptible to key pathology...

Imaging planes

IAC view with 4 nerves....

Reference

Lane JI, Witte RJ. The temporal bone: an imaging atlas. Springer. Copyright 2010 Mayo Foundation for Medical Education and Research

Axial image at the level of the left epitympanum. At this level, the head of the malleus and the incus have an ice cream cone appearance. The tip of the ice cream cone is the short process of the incus. Note the normal uniform, narrow malleoincudal joint.

Axial image demonstrates the dense region of bone surrounding the cochlea, vestibule, and semicircular canals called the otic capsule. This region is very difficult to fracture, requiring great force. Otic capsule violating fractures are associated with worse clinical outcomes, including CSF leak, sensorineural hearing loss, and facial nerve dysfunction.

The fissula ante fenestram is located just anterior to the oval window (red asterisk). Both crura of the stapes are faintly seen in this image immediately adjacent to the oval window.

The vestibular aqueduct is important to recognize as it can be associated with key pathology. Enlarged vestibular aqueduct syndrome is associated with sensorineural hearing loss. Endolymphatic sac tumors can arise near the posterior petrous ridge.