Temporal Holds
Common Holds
Overview
Temporal hold: Finger in the ear canal
The most common hold for the temporal bones is with the middle finger in the ear canal (it is actually very comfortable for practitioner and client), first finger on the zygomatic process and third and forth fingers on the mastoid.
Variations
Temporal hold: Holding the ear
In this hold the ear is used to orient to the temporal bone. The thenar eminence (base of the thumb) can rest on the upper ear with the thumb extending down to the ear lobe and the fingers behind the ear. Another version of this hold is the pad of the thumb and fingers grasping the ear.
Temporal hold: Adapted cradle hold
In this hold the first finger is allowed to contact the mastoid when in the cradle hold and the thumb can rest on the squama.
Treatment Notes
Temporal bones are in four parts at birth
Each bone contains a number of ossification centres. Some of the bones of the cranium can have many such centres. These centres start to develop from week 6 after fertilization. At birth the temporal bones consist of four parts: squamosal/zygomatic, petro/mastoid, tympanic ring, and styloid process. This is why the temporal bone looks like it has been stuck together from a number of parts. It also explains why the temporal bone has such an unusual primary respiratory motion - a 'wobbly wheel' motion according to W.G. Sutherland
Working with the Intraosseous temporal bone
The tympanic ring and styloid process are very small compared to the petro/mastoid portion (dense bone formed in compression from cartilage and containing the vestibulocochlear apparatus) and the squamosa;/zygomatic portion (thin bone formed in stretch from membrane). These two major parts of the temporal bone can get distorted at birth and affect the dynamics of the adult temporal bone.
Jugular foramen
Holding the ear is often used to orient to the jugular foramen. The direction of ease would be for the temporal bone to move lateral and posterior at an angle of around 45 deg, out and down, towards the table. This angle follows the axis of the petrous portion as it fits into the cranial base.