THE UNIVERSITY OF MINNESOTA

GRADUATE SCHOOL

Report

of

Committee on Examination

This is to certify that we the

undersigned, as a committee of the Graduate

School, .have given Dr. James L4!9 Rogers

final oral examination for the degree of Ophthalmology & Oto-Laryngology

Master of Sci~nc~ iQ~ We recommend that the Ophthalmology & Oto-Laryngology

degree of Master of Sci~nc~ infe conferred

upon the candidate.

Minneapolis, Minnesota

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THE UNIVERSITY OF MINNESOTA

GRADUATE SCHOOL

Report

of

Committee on Thesis

The undersigned, acting .as a Committee

of the Graduate School, have read the accompanying

thesis submitted by James Lee Rogers

for the degree of aster of Science in Ophthal , ology and Oto- Laryncolory

They approve it as a thesis meeting the require-

ments of the Graduate School of the University of

Minnesota, and rec ommend that i be accepted in

partial fulfillment of the requirements for the

degree of aster of Science in Ophthalmology and Oto-

.. t£~La-~yu.;:~·--·- ··-· c / Chairman

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OBSERVATIOrS 0 T ill D • LOP ''TAL

OlE

A Tl SIS

Subnitted to the Faculty

of the Gra&uate Schoolof

the Univeroit of innesota

by

Jan·eo Lee Rogers ,

In partial fulfillment of t e

Requirerr.e.ts forte de re of

raoter of Science in

Op. thalmo .... o ~r a. · Oto -Laryn olog

June

1921

ATO Y

OBSERV.Al'IOUS ON TEE DEVELOR.1ENTAL Al~TOMY

OF THE TEMJ?ORAL J30I~

Graduat theaia for at r 1 s Degree in Opthalmolog ar.d Oto-1 yngolog -Graduate School, University of Minnesota.

From the Institute of Jn.;..tom;y, the De artment of Opt:b..s.lmologv Oto-laryngology.

The purpose of.thia a r is to record aeries of observations

on the evelopnent of the temporal bons in later fetal life and childhood,

and to consider the varying rel tiona of its s veral rta t differ nt s,

~ith ticul reference to their surgic 1 aignificance.

The s~ baa b en limited, 1n the main, to those pha.aes of the

subject concerning which our info tion is obvioualy incomplete or upon

which there exiata cided difference of opinion.

thode

A con81 er bl amcunt of teri 1 w s v il ble for this 8~, in-

cl uding 94 t por 1 bone 8, 8om some fresh in situ, a well a

eri 8 of 32 lkulls 1n v ious et gee of eve1oxment. Ot the t poral

bones, 14 w r of fetal at es, 32 of ne born children, 18 of children of if-

f rent a ( ~ to 15 yeara inclusive) ani 230 of adults.

Of the llkulls 14 re fet l, 14 ere ne born, 4 re ot chil-

dren. Ther a a1 o vailab1e 1 rg a ri a of ult akulla for compe.rilon

ith those of earlier a gee.

To insure exactitude of 1\11'8 nta, to termine cur tely

th rel tiona of t ious ts of the or , the subj ct a

been ttaclted with v iety of methode.

F1rat, a a ri s of c sts in oo 1s met 1 8 , re ro :u.ci

the cavities of the external, m1 e inter 1 , to ether ith the

nerves, air cells, oa88UB itor,y tube, tensor tympcni scle, c rotid

') {\ ( f~ ;,1

rtery, aq,ue ucts, etc. In all 40 such caste were prepared. Fifteen of

these were of adult ears, 5 of children, 10 of newborn inta.nts, ani 10 of

fetuses. Drawings of aome of these prepa.r tiona re shown in figure 1 to

14 inclu iva.

Second, the antra. of a series of temporal bones were filled with

bianuth ete and radiographed to ahow their position t different agea . As

a check on this procedure, the antra. were 1 tar trans-illuminated by intro­

ducing the IIDAll electric light of bronchoscow tube in the cavity of each

bone ani tracing the outline on the surfooe. In older children 8l1d adult

a.n opening wa.a drilled through the tegmen tympani into the antrum to mit

th light. In the fetus ani infant the trum could be reached through the

external mea.tue. Q

The size and position of the antrz were determined by' r io-

gr :pey ani trans-illumi tion in 40 bones (10 adults, 7 children, 8 newborn

infants ani 15 fetu es). Drawings of these specimens are tilown in figures 15

to 4 inclusive.

Third, to determine the relations of the inner atructures of th

ear to urface landmarks, a. aeries of ca.ets in ood 1s m t 1 w 1 prep e ani iJ)

the.bone in these 8 cimens as later rendere tr ns nt by the S t hol

cle 1ng method so that the cochle , trum, nerves, air - cells, etc. could

be observe in situ. Three of these pre tiona were Of the , one

w s of ult, ono of a. child, three ye rs ol d, one of newborn infant

(Figures 25 and 26) .

Fourth, to tu.rther determine the rel tiona of the trum, facial

nerve nd other structures to the surf e lanliD.!:u-ks, regional iasectiona

were e on the cadaver . Of these 8 ere of the ult, 2 of chil ren, and

•·lU l 1

-3-

a of neWborn infants. The angle of inclinAtion of the tympanic membrane

was also a.etermined in 55 ear drums. Of these 6 were adult, 4 children,

24 newborn and 24 fetuses. .Aa a check on measurements am relations, 32

temporal bones were sectioned 1n various planes. Of these 20 were a4ult,

2 childr n and 10 newborn infants.

The value of the study of the middle and inner ear by means of

caate has long been recognized. As the p:neuma.tic cavities of the are

r ther complicated in shape, it 11 only by representing these space as

aolid that one can obtain a. clear concept of their preci form and extent,

and of their relations to one another an to the r~ighboring nerves, vesselt

nd other structures. Only by clear knowledge of the inti.Inate topographi-

cal rel tiona of the middle e r to the surrounding cavities ia the signifi­

cance of the frequent infl tiona of the former tully understood.

A variety of ma.teri la have be n used to replace th air a aces in

casts. :Benxol use a mixture of w ani resin. Von St 1n emplor d

a rubber an chloroform aolution, and then vulcanized the mass. Bruhl cle -

ed the bone nd inJected ~rcury. J. es Brown injected nt rubber

vulcaniz ood•s etal ans to ive the ost s tiafactory results for

this trpe of preparation, and cert in refinsments of the method introduced

here have been found of considerable v ue in securing ore perfect com-

let s ecimens.

To make casts of the middle i~r e , it ia beat to ecure

well ried temporal bones in l'fhich the nerves, mu.cous Jlbrane of the

c vitie have disintigr ted end is p eared, so that the canals will be

7-20 2.

· -4-

clear. If W'l¥ of these deseica.ted ti sues remain, they ould be removed

with the air bl st . The callB.l and nerve openings are then covered with

heaive t pe, with the xception of the external auditory meatu which is

left o~n. It is well to malts in holes in some of the canal ox:enings, and

to ~lace small ieces of cotton over them to receive the displaced air. The

bone is now enc sed in a. thick lqer of plaater of Paris except for the are

immediately around the external auditory meatus . After heating the encased

bona t about 100 degrees centigrade for 24 hours in sani b th, it 1s

re~ to receive the mol ten ood • s metal"' which is poured into 1 t to the

level of the supr atal (Henlet' s) opine . . As the bone i heated above the

melti point of the metal, the 1 tter will not solidify, and the specimen

can e itated to r~ove air bubbles. It is a. go~ la.n to drop ~ little

w ter on the metal t the meatus to solidify it then the bone c n be ick-

ed u , and rot ted to remove the a.1 r get the metal into all rts. After

coolin , the plaster of Paria sin is removed and the sx:ecimen is aced in

3 per cent cy rochloric a.ci to ditsol ve the bone.

Techni ue of Prep&:ring Tra.ne rent :Bone Specimens.

The ethod used to renier the injecte s ::ec~en of bone trane-

rent, s ehorn in figures 25 and 26, 1a that developtd by Sp tehol of

~J) Lei zig 1n 1906.

After the tampor bone is filled with ood 1s ~et 1, it is decal-

cifi , qy 1 cing it in two r cent solution ot hy rochloric acid hich

i ch e ·daily for one month. It is then trans! rre to one - r cent

- - - - - - - - - - -

* oo s etal is co posed ot t i n 4 ts, le 8 ta, bi~th 16 rts

c ium 3 ts . It s very lo elti

centi r e.

-5-

solution of hydrochloric acid which is for two weeka. The

purrose of this procedure is to secure complete dec lcific tion of the bone,

without destroying the specimen with the acid. The bone ia then wash d in

runr.d w ter !or two weeks, or until it gives neutrgl reaction to blue

litmu.s, after which it 1a bleached for two hours in hydrogen peroxide and

a.in washed. After bleaching, the specimen i ain w shed, and i tben

dehydrated by ssing it through aeries of graded alcohols of 60, 75, 95

am. 98 per cent. It should be left in each mixture a.b011t 24 hours. After

de¥ra.tion, the specimen ia cleared by placing it in benzol !or tr:ixr da.ya,

cha.llging the solution t tho em of 48 hours. The fi~l pre rving fluid

in which the apecimen is to remain, consilta of met 1 1 Hcylate 5 rt s, an!

iaoaa.frol 3 parts. As the fluids have the e refractive i:oiex a the

prepQ.re bone the 1 tter becomes tr nslucent. ~timea it be

tr na:pa.rent by ing littl mor iaos rol. Air bubbles be r ove by

.t'la.c i the a cimen uni r bell j r exhausting the r with ction

Obs rv tiona.

The r ~ymp:mi. Upon e.xumination o t~ lit r ... ture on the ~c

co rented with ii. e t v ri e o o i io re tion of thi

stru.ct\lre. Observers to be bout a to th r the in-

eli .... tion in th :.6\Vborn is to, or 1 s t t t f the ult,

veral nt in t t the r oat horizont 1 ~t i th.

The le given Luci r the Jlt i s { '1.7}

c 1'1 1~ ' (_i7) (2.7) (!~) l17) {17) .t_.,}

Fli t 45, Zir ~ , Piersol ~ , Gr) o, ~orri , • ili h (1.) ~ , ton

L1-sJ ( 1-~ f.1.1J (~v) 46, ~. Poll 45. v, Gri y, H ~ , von Trolt ch, Grube~ Che tla(7)

s ~te th t the t • br~e is ly lloriz nt t birth, bile

-6-. ul t u.nd.

;hewborn is about the s e . The d t obta.ino by the measurement of indi-

vi uaJ. e e1rums in this tudy io ahown in the following t ole (T~ble Uo. l).

The figures 1. ica.to the degree of incli tion from the :perpendicul r. The

a.I'I.U ente .... s iven in T ble 1t.unb·er l ahow thbt large individual vu.ri...-

tion is fre :u.ent in both new born nd. :u.l t drums. The ver~gas Show the

embrana p roaches little more closely the horizontal in the fetus and

thu.t it adually becomes ore erect in l ter fet life . There seama to be

no const t change in the gle fter birth.

10 ... 1 1 s ".., i v n in t ... 1 o 1'1 L. t lo' rc. ~ tor .:..n d ;ith

• 1oter o1 • 1 ~ .... tm ·e 1-..)

~rtin ~ R 1 ~e . ') . -

•-lll ~ 1

-7-

T ble 1.

Inclination of the T1m nic Mambr

Four months fetus

Five "

Six 11

Seven 11

Eight

Uine

II

II

Newborn

II

II

II

" II

Chil of three ye

ult

I i vidual C se s

61 ,63

55, 57 J 6 1621 '7' 1 8

58,59,6 ,64,64,65

55,6 ,61,62,63

58,59, 6 , 65,65

55,57,57,61,62,63,63,68

54,55,56,57,58,6 ,60,65

55,6

4 ,55,57,6 ,6 ,69

Average Degree I of Inclination

64. 4

61.5

60.2

61.'

6 .a

57.

57. 5

57.5

-8-

T 1 2.

Dimensions of the Tympa.nic m'br eter

Di ters (mn)

Fourth fetal 6.8, 6.8 6.8 month n. 5.5, 5.5 5.5

Fifth et 1 x. 7.1, 7. 5, 7.5 7.4 month in. 6. , 6. , 6.5 .~

Sixth fe 1 x. 7.2, 7.31 7.2' 8 7.6 m nth Min. 6.31 6.6, 6.61 7.5 6.7

Sev nth fet 1 x. 7. 8, a. ' 9. 8.3 month Min. 7.6, 7.7, 7.8 7.7

Eighth fet Max. a. I 9. , 9.6 8,9 month !in. a. I a. ' a.3 7.a

Ninth f tal x. 9. , 9. ' 9.2, 9.7, 1 9.3 month n. 7.51 8. '

8. ' a. 51 8.5, 9 a.~

w'born ·x. 9. I 9. I 9.3, 9.5, 9.51 9.8, 1 • ' 10. I 1 . , 1 • ' lv. I 1-.~.2, 10.3 9.8

fin. 7.8, a. '

a. I 8. ' a. I e. ' e. '

8.2, 8.3, 8.4, 8.4, 8.6, 8.8 8.2

Sev n month x. ll.

chil n. 8.6

ye x. ll.

child Min. 9.

1\To ye x. 11.

child 9.

ult 11. 9.

·-U 2

-9-

Aa the me su.rementl wer taken to the extrem edge ot the sulcua

trznpanioua they will be fo'Ulld to be slightly larger than the rum membr

proper.

It is generally 1t ted that the dimenaiona of the tympa.nie membr a

at birth are almost identic 1 with those of th adult, there b ing little or

no increase in the po t=.na.tal period of developnent . The figurea uoted in

T ble NUmber 2 &how that the ~panic membrane increases ateadily in size in

the l~at half of fetal life and that so there is distinct increase in ita

di ete~ in the first year ter birth,

dimension ~re attained.

t the nd of which period the ult

The Antrum

The " 4a.atoid" Antrum should be called the tym o antrum becaua ,

conai ered fr~ ~ point of view, it i plrt of the tym we c ~i ty. The ·

trum ap s in the f tus .... t the s time s the trm 0 c :vity, t

the time of birth is velo d to about ult enaiona, but the stoid

cell do not ~ar until the aecond ye

till the fifth. Definite r cella first

they e nerally di.loetie ~

ar t the venth or eighth y

e first een s well d velo a e a fter th ninth y r. The trum

must also be consider t 1 s s a continuous with the tym c cavit

• ly1n entirely within the petroua bone. It il cover d by thll te n

t1mpan1 which so is the roof of the tym c c vity the auiitor.r tub .

The rel tiona of the ntrum to its jacent structure• v ry conaid r-

bly t ifferent gee. U to the time of birth it ia irectl over the

atus, its up r t lyi bove the zygo tie oceu ita terior

in exten ing forw beyon:l t t of the tu . t·le fet r anc ne bor

1\ "·;he incus lies in th its long roject& into the oces

tr As Shown in figures 15 to 4 inclusive, s the chili o a ol er the

I• U J.,

-1 -

trum ly ahifts fro its loc tion ove the mea~s to more posterior

and inferior position, and in the ult it i directly .oaterior to it . Ita

~ ition in the child terially aids dr ge in acute infections.

The later (external) c ~1 of the bo~ l byrinth forms the inner

bouniary between the trum aM. epi tym nic recess. Ita boey covering h

easily recognized a thin white rid of dense bone. In th young child itt

wall 1 only about one-fifth of a millimeter in thicknesa, prob or

curette introduced into the iddle e , could e sily rupture into tbs c nal.

The thickness of the bone para.ting the antrum l ter l c 1

different es, it prox1moo.tely a.a follow• :

ewborn Thre Years 01 Five Ye s Old ult

.Zn:m 0.3 to • 5 Illll .s m:n 1

As the stoid evelops, the antrum b comea f ther f ther re-

moved from the exter surface of the bon!' . Th thickneaa of the

boey wall, bouncUng the 1 teral surf ce of the o.ntrum t different 1, is

;pproximat ly • follows :

born

1 to mn

Five Ye a 01

6tllll

Ten Y rs Old

1

The above figures re bout the a tho gi n

ult

15

Symin on

(.c;;· ) • The d nlion• of the antrum in the ne orn are about l by 11

which 1a tely the s in the ult

The Fa.c

t

Tho ner 1 course r 1 tiona o! the f ial rve in t t .~r 1

bone e much the s in the inf t ul t, ni there a to e con-

sistent uniform growth of 1 t s rt s . The di at n;:e fro the ner e 1

ntr e into the internal itory atua to the centr 1 int of the ni-

nglion ia shown i n the following t ble:

•·J. J. I

-11-

Five month Seven month I wborn Three year Adult fetus fetua (g.ver ge) child ( .verage)

of·1o c s s of 1 cc..aes

a 9mn 1 mm l2m:o. 13

The distance from the center of the g lion to the point where tbe

nerve turns shar 1y downv d is 10 mn in the newborn, ll mn at three yea.ra,

ani an average of 13 mn in the adult. Thil portion of the nsrve 11ea within

the tym:pa.nic ca.vity ani in its course over the promontory o'Ulld the ter. st

rotundum it ia protected only by thin ahell of bone in th ult r in

the child. u:t- to the tourth year it is often cover "'l only by thi~ embr I

of connective tis~e. This exposed condition accounts tor the li bility to

faci~l paralysia in the c!hild follo r~ing cute oti 18 m di • A the nerv runa

irectly bene~th the anterior ~rt of the ext 1 (horizont 1) 1,

}.)robe or S ke '• irector for locw.ting the e

e sily injure it. As Che tle t7) ptly a a, "Su.ch instr nt 11 e

only in e arienced hands, t n it 18 not ne " The course relatione f t f~i rv c n e best n in the

u rior views of the v rioua c sts. The hta.nce fro the at rior rim of

the tym c the n reat oint ~rve, 1a fr 3 to

oth in the fet:ua the ult.

The exposed conHtion o the rve, in r1y lif , t r ita xit

fr the atylo stoid for n, 11 of 1m or oth to the obst trici

tho 8Ur on. In the fetus youn infant, it r a ... bout 3 ehi

little b low the oat osterior t of the in of the tym c br

As ther ia r..o stoid ocess t this ti , the nerv runa do . rd over the

troua ortion of the bone. This coxdi Uon e.ccounta or some of the fa.ci 1

r~lraes 0 :uced by es~e rGn instr er.ta t this r int uri elivecy.

1-lU l

It is so to be th-t thia externtll or ion of the n rve liea in the

th o! -n izciaion wuch a is e in oper tion or atoiditia in the ult.

It such ~ i cisio:c. wer e in the in! t, the ner e would e cut n1

f ci alyail v oul reaul t; but ... a the .:.ntrum in the young chil 1a much

hi ar , and s there ia o atoi cont ining ir cella, there is little ne

for ch incision. The ral tiona f t exit of the t i 1 nerve,

th trum, the tympanic embrane,

ahown i figure a 15 to .04 incl uei ve.

the developin atoid proce11, e

Atter the first yo , the ve tic 1 rtion of the t • rve ia

adually covered by the epoait of the 1 yers of bone forGdng the atoi

roceaa, nd tv the outw r gro th of the :posterior portion of the t panic

ri hich forms the xter 1 o seua tua. The thic 11 of t bo o r

this Qrt ion of the %113rve it shown by the following sur nta:

thr e ye rt, 6 to 1 Fiv

In 11 ~ t na e

to the surf e, ut aFr ili (ll) at t a,

A ndi th 8 e sea ..,.

ill~eters lo er.

The Inner _

If linea ere rojeet d throllgh

t little . at rior to the bypohyaia,

u.lt 13 to 1

in , the

i n c sea t e ..

the exit oul •

ODSy

tr 1

r b

o or t

icirC'Jl r e !'I t

be" t right h ot r. t c be

a of o aide re t ri t lea, th t it en that the e

of one side it t ri t ngl 8 to ita te on the other ei e.

r,

th oaterior canal of on si e r llel to tbe IU rior c l o! the oth r

nl Vice vera • Thia 1s shown in figures 29 to 3 ·

t

-13-

Upon su.rement, 1 t will b found tha.t in only bout third of

the cases will these es be exactly 9 d. rees. Other c a will vary l

e rees above or elow.

Th linea projected hro h the perior c nal of the n vborn t

'i thi the for n gnum while i .. the :u.l t they meet well back of it. This

ia tly :u.e to the f ct t t the or n magnum it f rther osterior in the

infc.nt , ull ~ partly b~ca:u.se tbs w rior c l lies more n erl in the

tr~averse lane. The lines runni orw d through the osterior c 8 0

the newborn et in the region of the clivus while in the ":u.lt they eet

f~ther orwar in the re ion of the sella.-turcic . Thit 1t also due to the

f ct t t the Qsterior c nal of the newborn lies ore ly in the tr na-

ver lane then that of the ul t.

Ale · er (l) ...:ld Sha.w (18) found the ult imer e 1 ger t

t t of tho newborn. Bo th (3) fo'l.llld the .ost mbryonic growth to be bo t 18 •

~ tle fo

there is

th i r e r of the :u.l t child bout the lize but t

incr ase in size in old e . The d tor• at ifferent til

own in t bl ber 3 4.

The inner ear c~ea t little in size t r th fifth fet 1

o th, a 111 ahown in the ollowi t blea (l~b r• 3 & 4) ·

-15-

T :tl1e No. 3

I&..ximwn le th of inner eCl.l' t includin cochle , ve:ttibu.le a:ld

posterior canal .

Five ont fetus

Sev n ontlu fetus

Newborn

Three eca-> old

Five ye ... ~ old

ult

•

PJ:·ea nt s ries

18

18 mil.

17

18

16 IllDl

18 mm

Alexander (1) Seibemaml (17)

15 IllDl 19 um

18 um 18. 5 IllDl

w (18)

18

-16-

Table No .4

Diameters of the Inner Ear Parts t Different Ages

Vertical Horizontal Ant. post. Vertic diameter diameter of diameter of diam. of of cochlea. au:p. canal external c~l st. canal

Five months fetus 7.5 nm a. um 7. mrn 8 . m:n

Seven months fetus 7. rmn 7.5 m:n 7. rmn

Newborn 7. mm 8.5 nm 7. 7.25 nm

Three years ol 7.5 mm 8.25 7. mm

Five ye r.s e. old 7.5 mm a. 5 mrn 7. mrn

ult 7.5 mn 8.5 m:n 7. m:o. 8. Dill

Seibenzrnzm (17) 7.2 m:n Newborn 7. 7 m:n 8.8 n:m 8.1 m:o.

:Ill t 7.5 u:m 8.6 7. Dill 7.2 mm

Shaw (18) Newborn 5. mm

Adult 6. Dill

,.JO l.

-17-

l a t eral l .1. a c e The distcance of the horizontal c nal from the 1\ . . in the infant

is from 4 to 6 mm while in the adult it i a from 12 to 20 n:m. 'l'he horizont l

Canals ani: the oval winiow are the moat fre u.ent :t-'Oints of entrance for in­

fection. The angles of the semicircul r c~la to each other ani their :poai-

tiona in relation to ~he rest of the ak.ull a.re shown in figurea 29 30.

The relation of the semicircul r nal to each other is shown in

the following table. The figures indio to the degree of the angle. (From

Sio boDnaM (1 7) ) ,

Adult

.. ew'born

Superior to external

az. 85.

Superior to poaterior

79 .

88.

"' Ono of tho angles tt.Jten in this serie of four ca.sea Which accounts for thit large a.ngl.e.

- - - - - - -

Potterior to exter l

99 ....

92 .

a,

Mo t gr tetul thanks are ue Profeaaor on for hel a in

• CUring at criticizing the text of th11 il8r ·

Pl tes Noa. 1, 2 & 3

Casto of i ior ani middle ear.

Pla.te No.1

Wood 'a met 1 casts of internAl ni iddle ear of fetu ani

newborn.

Xl - (ma.tur 1 si:t.e)

P1 te No.~

Wood t s metal casts of internal and middle ear of :cewborn

and child.

X1- !~tural si %e)

Pl te No. 3

Wood t metal C<;.sta of inter 1 ani middle ear of child. and

ud.ult.

Xl- Natural i -z.e)

Plate No. 4

A series of temporal bones ahowing the polition of the ntrum

aa deter.mined by X-ra1 and transillumination.

Figure 15, Newborn

Figure 16, Sevenmonthschild

Figure 17, One year old

Figure 18, Two year& old.

Figure 19, Thre ye old.

Figure 2 , Four ye $ old.

Figure 21, .Five y rs old.

Figure 22, Ten ye rs old

Plate No.5

-19-

Figure 23, Lateral view of slalll of newborn child showing

position of tympanic antrum a.a determined by X-rq ani

transillumination.

Figure 24, Lateral view of adult skull showing position of

tympanic antrum a.s etermined by X-rq and transillumination.

Plate No. 6

Figure 25, Lateral view ot temporal bone of newborn child

which lw.s been ir.jected with iiood 's met l am cle red with

Spalteholz's method • X lt •

Figure 26, Medial view of same apeci~n as Figure 25. X l

Plate No.7

Figure ;:,7, Dissection showing position of antrum in relation

to external oseeus meatus in newborn child.

Figure 28, Dissection ahowine position of antrum in relation

to external osaeus me~tua in the ult.

Pl te No.8

Figure 29, Drawing of the b se of the skull showing the posi­

tions and ~lea of the ~perior ana posterior semicircul r

canals in newborn child. X

Figure 30, S£,lme s Figure 29 of ul t skull. X

-20-

REFERENCES

1. Alexander, G. Zur Fraga des postembryonalen Wachstums des

menschlichen Ohrlabyrinthes. Anat . Hefte. XIX, (1902) ,

571-()78.

2. Alexander, G. Diseases of the Ear in Infancy and Childhood ,

Translated by A. Bedell. Sec. Edit . Pg. 1 - 46 .

3. Boot, G.W. Development and Structure of the Temporal Bone .

Journ. Amer. ~ed. Assn., LV , 563-565.

4. Brown, H.B. The Infant Temporal Bone in its Relation to the

Mastoid Operation. Bull . Lying-In Hosp. City of New York.

Vol. IX (1913) Pg. 11.

5. Brown, J . Bull . of Med. Dept. of ash. Univ. Vol . IV , o. I ,

Aug. (1905) .

6. Cavanaugh, J •• Topography of the Tympanic Cavity. An ale of

Otol. Rhin. and Laryng. (1913) Vol. XXII. 699-716.

7. Cheatle, A.H. Some points in the Surgical Anatomy of th~

Temporal Bone From Birth to dult Life. Londo 1907.

8 C A.H. 1 • heatle, • The Report of An Examination of Both Tempora

Bones from One Hundred and Twenty Individuals in Refere ce

to the estion of Symmetry in Health and Disease.

Otol. Rhin. and Laryng. Vol. XXII, 19-125.

ale of

9. Clark, J.J. Some Observations on the Temporal Bone, Chiefl in

Childhood. Journ. Anat . Physiol . , VII N.S . (1893), 411-414.

10. Courtade, A. Anatomie lopographique comparee de l'oreil

moyenne chez 1e noufveau-n~ et chez l'adUlte . Ann. d ~al. de

l'Oreille et du Larynx. XIX (1893) 682-688 .

11. Freligh, . C. A. The temporal Bone and its omalies at Birth in

One Hundred Fifty Cases . Bull . Lying- In Hosp . City of e

York, Vol . IX (19lj)Pg. 3.

:

-21-

12. Guthierie T. The Development of the Mastoid, British Mad. Journ

Vol. II Oct. 1907 Page 986.

13. Metheny, D.G. Some Points on the Applied Anatomy of the Tempera

Bone. (Reprint) Penn. Mad. Journ. Dec. 1915.

14. Politzer A. The Anatomical and Histological Dissection of the

Human Ear in its Normal and Diseased Condition. (English

translation of G. Stone.) London 1892.

15. Prinz H. The Spalteholz Method of Clearing Animal Bodies. Journ

of Missouri State Mad. Ass'n. March,l913.Pgs. 295-299.

16. Rouviere, H. Sur le d~veloppement de I~ amtre mastoidiejret des

cellules mastoidiennes. Bi~liogf Anat., XX (1910) 24-34.

17. Siebennann F, Die Korrosion- Anatomie des menschlichen Ohres.

Wie sbaden 1890.

18. Shaw, A.J. A Few Anatomical and Clinical Feints in the Ear of

the New-Born Infant. Amer. Gyn. and Pediat. XIII, 127-142.

19. Stewart, W.H. Radiograph Findings Illustrating the Anatomical

Development of the Mastoid Bone. Annals of Otol. Rhin. and

Laryn. Vol. XXII (1913) 677 and 833.

20. Symington, J. The Mastoid Portion of the Temporal Bone, Edinburg

Mad. Jour. 1886 Pg. 293-298.

21. Trait. d Anatomie Top. 3rd Edit.

22. Tre es, F. Surgical Applied Anatomy. Seventh dit. pg. 91-102.

23. Spa1teholz, D. • Uber das Durchsichtigmachen von menschlichen

• und tierlschen PraparatC~, Leipzig, 1911.

24. Henle, J. Allgemeine Anatomi~ Lehref von dei ·~chfn und

Fermbestandtheilen ~es ,Ple·nschlichen Korpers. Leir>sig, 1841

Henle, J. Handbu/ch der Eingeweidelehf des Menschen. 1866.

25· Pollak. Diseases of the Ear. Pg. 20- 1883.

26• Gruber, Jos. Diseases of the Ear. Pg. 51. Sao. Amer. Edit.

- 22-

£7 . Textson Anatomy and Physiology. I

Luciani. Pg . 198 . Vol. IV, 1917.

Howell , Pg. 380 . Fifth dit .

lint . P0 • 715. 1905.

Kirk. Pg. 739 T· entieth ' it .

Piersol . Pg . 1494. 1907.

Gray. Pg. 1126 Seventeenth Edit .

orris, Pg. 1052. Fourth Edit .

tana\

. semicirG. canal

_5 MO. fETU.S- l ATERAI-Vt!..W- (LEFT)

7,· q . I

7Mo. f'E.Tu~ ... LAT~RAL. VJE.W- (Lz:n)

J

Nr:wsoR.N-LATtRAL. VtE.w - (LEFT)

5Mo. fuu.s -SuPtP.toRVtEw-(LErt)

2

Int. moa.tl.l$ for 7th 6"1 8th nerves

<len. gan~ . & 7th. nerve

Antrum Tymponi' (ovlty

----txt. rneo.nu 14n.sor tympani m\ade

Al.lditory tu.be

7Mo. f&Tus -5uPIRIOf\ Vrc.w- (L.uT)

Ten~or tym­pani mu4de

Auditory tube

4

5emicircu.\ar canal.)

7th nerv&

NE\VBOP.N- .SuPE.P.JOR. Var.w-(LEFi)

'"' c

tnt. meo..tu.& ~ Tthn~rve

Coc.h\e.o.-

:)emic.&Ycu.lo..Y c:o..no..\

Ext~rn<ll meo..tu.~

NEWBORN- LAT E.RAL YIEW-(l£.1'T)

7r·( 7

GTt. for.

Int. meo..tu.~ ---/'

Gen. gang.~~~~:·, (!) '1'1h. nerve ~

Au.ditory tube

N~WI!!I0Rt1-5UPERIOR VI~W- (LEFT)

7t"y ~

GenicuiGte go.nqlion 6'1 Tth nerve

lnterno.l meatus Cochlea.

for .. of 7th nerve

Tympanic cGvi1y

.3YR. CHIL.C -SuPERtoRVa~w-(R.ac.HT)

....

Tensor tymponi m~.t6de

Auditory tube

I Ca.rotid a.rtery

5vl\. CHILD- LATERAL. VtEw-(1..E1'T)

7 t' lf. 7

Aud1tory tuba Ten.s.or tympani musdl!.

5c.mic.irc:u\o.r c<:Wla.l~ /Antrum

r.--..-::::-.ilt'"""

'- Externo.\ mea t u.s

5vR.. CHILD-SUPLR.IOR. v.r.w-(U.n)

ADULT -LAT£RA\. VIEW- (Ll.FT)

Clr.reatcr aupcrfic.io1 pcttoso\ nerve

~

lnt .rncoha

ADULT -SUPERIOR. VIE.W-(lLn)

'

I '

17 /'¥

-1 t ~-( . .2..3

f

-~

J. j q. 1 7

- Adu\1 -.Sholl.,-mg po:.ition of co.nz,b in re\z,..tion to

ee>ch other o.nd to plone::, of .':'>k.ull . (from di:;~ection)

~ ,· 1 :z. 1

" l

Po~terior c.<~.nb.l

- Ne:wborn -0howi~ po.sit ion of co.ne.l.s in relation to

ec.ch olhe.r and to plane::; of .:~kull. (From di5s~ction)

"7-l·f. ) .

....

•