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The variants of the retro- and hypotympanum: an endoscopic anatomical study.
Journal article

The variants of the retro- and hypotympanum: an endoscopic anatomical study.

  • Bonali M Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
  • Anschuetz L Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Modena, Modena, Italy. anschuetz.lukas@gmail.com.
  • Fermi M Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
  • Villari D Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
  • Mariani GA Department of Biomedical Sciences, Medical School, University of Bologna, Bologna, Italy.
  • Manzoli L Department of Biomedical Sciences, Medical School, University of Bologna, Bologna, Italy.
  • Caversaccio M Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
  • Presutti L Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
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  • 2017-03-01
Published in:
  • European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. - 2017
Endoscopic ear surgery
Finiculus
Hypotympanum
Middle ear anatomy
Ponticulus
Retrotympanum
Sinus tympani
Subiculum
Anatomy, Regional
Cholesteatoma, Middle Ear
Ear, Middle
Endoscopy
Female
Humans
Male
Reproducibility of Results
English The retro- and hypotympanum are hidden areas of the middle ear, only poorly recognized. Nevertheless, this region is of relevant clinical significance, since it is regularly affected by disease such as cholesteatoma. The aim of this study is to explore and describe the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy. We hypothesize a significant variability of this hidden region of the middle ear. Moreover, we believe that the minimal invasive, endoscopic access is suitable since angled scopes may be used to explore the region. To this end a total of 125 middle ears (83 cadaveric dissections, 42 surgical cases) were explored by the means of 3 mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge-shaped only in 8% of the cases, the finiculus in 17%. The sinus tympani had a normal configuration in 66%. A subcochlear canaliculus was detectable in 50%. The retro- and hypotympanum were classified, respectively, to the present bony crests and sinus in a novel classification type I-IV. In conclusion, we found abundant variability of the bony structures in the retro- and hypotympanum. The endoscopic access is suitable and offers thorough understanding and panoramic views of these hidden areas.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/278699
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