8 SURGICAL APPLIED ANATOMY. |Ch.<p. i 



is absorbed it leads to more or less prominence of the 

 zygoma and malar bone, and so produces the project- 

 ing " cheek bones " of the emaciated. The temporal 

 muscle above the zygoma is covered in by a very 

 dense fascia, the temporal fascia, which is attached 

 above to the tempoi'al ridge on the frontal and pari- 

 etal bones, and below to the zygomatic arch. The 

 unyielding nature of this fascia is well illustrated by 

 a case recorded by Denonvilliers. It concerned a 

 woman who had fallen in the street, and who was 

 admitted into hospital with a deep wound in the 

 temporal region. A piece of bone of several lines in 

 length was found loose at the bottom of the wound, 

 and was removed. After its removal the finger could 

 be passed through an opening with an unyielding 

 border, and came in contact with some soft substance 

 beyond. The case was considered to be one of com- 

 pound fracture of the squamous bone, with separation 

 of a fragment and exposure of the brain. A by- 

 stander, however, noticed that the bone removed was 

 dry and white, and a more complete examination of 

 the wound revealed the fact that the skull was un- 

 injured, that the supposed hole in the skull was 

 merely a laceration of the temporal fascia, that the 

 soft matter beyond was muscle and not brain, and that 

 the fragment removed was simply a piece of bone 

 which, lying on the ground, had been driven into the 

 soft parts when the woman fell. 



Abscesses in the temporal fossa are prevented 

 by the fascia from opening anywhere above the 

 zygoma, and are encouraged rather to spread into 

 the pterygoid and maxillary regions, and into the neck. 



The pericranium in the temporal region is much 

 more adherent to the bone than it is over the rest of 

 the vault, and subpericranial extravasations of blood 

 are therefore practically unknown in this part of the 

 cranial wall. 



