Objective To establish a consistent surface bony landmark for a middle fossa approach (MFA) lateral craniotomy represented by the squamosal suture (SS). Methods In 60 dried skulls, we assessed the relation between the SS and the external auditory canal (EAC). The lateral portion of the middle cranial fossa floor was also assessed for a possible relation with the anteroposterior diameter (APD) of the squama temporalis (ST). Clinically, we applied our findings on the SS in MFA for different lesions. Results A vertical line at the EAC divided the ST into the anterior part constituting 61% of the APD (i.e., two thirds) and the posterior part forming 39% (i.e., one third). The average ST height was 35.92 mm. The SS posterior limit at the supramastoid crest was located just anterior to the external projection of the petrous ridge in 35 skulls (58%) and exactly corresponded to it in 25 skulls (42%). The APD of the ST equals on average 97% of the APD of the lateral middle cranial fossa. Optimum exposure of the middle fossa was obtained without any further craniotomy extension. Conclusion The SS serves as a consistent natural surface bony landmark for MFA. Optimum craniotomy, two thirds anterior to the EAC and one third posterior, is obtained following SS as a landmark.

Abstract Objective: The primary objective of this study was to assess central auditory functions in a group of primary school children with dyslexia mainly phonological awareness problems and to compare their performance with children with good phonological awareness ability. Design: A group of 52 students with phonological awareness problems (according to their performance in phonological awareness subtest of Arabic Reading Test (ART)) and 31 age- and sex matched students without phonological awareness problems participated in the study. All children were free from any neurological problems, had normal distant visual acuity, normal peripheral hearing sensitivity in both ears and IQ equal or above 90. The children from both groups were subjected to central auditory tests (CAT). Comparison between both groups in their performance in CAT was done and the correlations between CAT and items of phonological awareness subtest were examined. Results: The students with phonological awareness problems as a group performed significantly poorer than controls on all central auditory tests. Also, there was a significant correlation between the speech perception in noise test (SPIN) and phonological awareness in the left ear mainly for (Recognition of the middle sound of the word, Deletion of the middle sound of the word and Addition of a sound to the word). Conclusions: The group of children with phonological awareness problem showed clinically significant diminished performance compared to the group without phonological awareness problem, reflecting difficulties in the processing of auditory information.