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A foramen may be present in the petrobasilar fissure in front of the jugular foramen through which runs the inferior petrosal sinus.
The temporal lobe, now slack from the mannitol, is retracted from the bone of the middle fossa floor, with care taken not to cause traction on the greater superficial petrosal nerve.
In the region of the ear, the tympanic bone is semicircular, and the petrosal is massive and only loosely bound to the basicranium.
If the results of the work-up to this point are equivocal or the work-up suggests ectopic ACTH production, inferior petrosal sinus sampling is indicated.
Impulses are conveyed via the glossopharyngeal nerve then via its tympanic branch to the tympanic plexus thence to the otic ganglion via the lesser superficial petrosal nerve.
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