Abstract
Problem
Early studies report detailed microscopic anatomy of the anterior epitympanum, yet none describe its anatomy from an endoscopic point of view.
Methods
Thirty-five temporal bones were dissected, and the anatomic details were studied utilizing an operating microscope and otoendoscopes with 0o, 30o and 70o angles and 2.7 and 3 mm diameters.
Results
Marked variation in the size and shape of the anterior epitympanum was observed. The recess was found in all of the 35 bones. In 43% of the specimens, the main cavity was above the tensor tympanic fold, it was best endoscopically approached via the posterior transmastoid approach. But in 49% of the specimens, because the recess was divided into two cavities by the tensor tympanic fold, it necessitated both the transmastoid and the transcanal routes to endoscopically approach it. While in 8% of specimens, it was mainly endoscopically approached via the transcanal approach, as the recess was contiguous with the eustachian tube.
Conclusion
The shape of the anterior epitympanum is influenced by the relation between the cavities above and below the tensor tympanic fold. The incorporation of otoendoscopes helps in more exposure of its different types with less aggressive approaches.
Significance
Review the added value of intra-operative use of otoendoscopes to approach the different areas of the anterior epitympanic region.
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