The temporal fossa is the shallow concavity on the lateral skull above the zygomatic arch, bounded superiorly and posteriorly by the temporal lines, inferiorly by the zygomatic arch, and anteriorly by the frontal process of the zygoma. It is filled by the temporalis muscle and its overlying deep temporal fascia. The middle temporal artery, the middle meningeal artery branches, and the deep temporal nerves traverse this space.
The temporal fossa is the standard surgical corridor for pterional craniotomy (the workhorse neurosurgical approach for circle of Willis aneurysms and skull base lesions), where the temporalis is elevated from the temporal fossa floor after the temporal fascia is incised. Temporal fossa epidural haematoma from middle meningeal artery laceration at the pterion is the classic neurosurgical emergency approached through this fossa. The temporal fossa is also relevant in coronal approach facelift surgery where the subperiosteal plane is elevated in this space to release the zygomatic arch periosteum.
Middle meningeal artery laceration from pterion fracture accumulates arterial blood in the epidural space within the temporal fossa, producing the classic lucid interval followed by progressive contralateral hemiparesis and ipsilateral pupil dilation; emergency temporal craniotomy evacuates the haematoma and coagulates the bleeding artery.
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