Abstract
The middle ear cavity is situated in the center of the temporal bone, at the intersection of two axes: the lateromedial axe between inner and outer ear canals and the postero - anterior axe between mastoid antrum and Eustachian tube. This chapter describes in depth the advanced anatomy of the four walls of the cavity, its roof and its floor along with their developmental stages to better understand the particularities of the anatomical key structures always in relation to surgical interest. In this second edition a concise knowledge concerning the mechanics of the tympanic membrane and middle ear is reported to better correlate anatomical details to function and surgical reconstruction..
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References
Langman J. Embryologie Médicale. Paris: Masson; 1965. p. 34.
Michaels L. An epidermoid formation in the developing middle ear: possible source of cholesteatoma. J Otolaryngol. 1986;15(3):169–74.
Michaels L. Origin of congenital cholesteatoma from a normally occurring epidermoid rest in the developing middle ear. Int J Pediatr Otorhinolaryngol. 1988;15(1):51–65.
Paço J, Branco C, Estibeiro H, Oliveira E, Carmo D. The posterosuperior quadrant of the tympanic membrane. Otolaryngol Head Neck Surg. 2009;140(6):884–8.
Daphalapurkar NP, Dai C, Gan RZ, Lu H. Characterization of the linearly viscoelastic behavior of human tympanic membrane by nanoindentation. J Mech Behav Biomed Mater. 2009;2(1):82–92.
Gan RZ, Feng B, Sun Q. Three-dimensional finite element modeling of human ear for sound transmission. Ann Biomed Eng. 2004;32:847–59.
Zhao F, Koike T, Wang J, Sienz H, Meredith R. Finite element analysis of the middle ear transfer functions and related pathologies. Med Eng Phys. 2009;31:907–16.
Shrapnell HJ. On the form and structure of the membrane timpani. Lond Med Gazette. 1832;10:120–4.
Henson OW Jr, Henson MM. The tympanic membrane: highly developed smooth muscle arrays in the annulus fibrosus of mustached bats. J Assoc Res Otolaryngol. 2000;1:25–32.
Adad B, Ragson BM, Ackerson L. Relationship of the facial nerve to the tympanic annulus: a direct anatomic examination. Laryngoscope. 1999;109:1189–92.
Makino K, Amatsu M. Epithelial migration on the tympanic membrane and external canal. Arch Otorhinolaryngol. 1986;243(1):39–42.
Lim DJ. Tympanic membrane: electron microscopic observations, part I: pars tensa. Acta Otolaryngol. 1968;66:181–98.
Lim DJ. Structure and function of the tympanic membrane: a review. Acta Otorhinolaryngol Belg. 1995;49:101–15.
Lim DJ. Tympanic membrane: electron microscopic observations, part II: pars fláccida. Acta Otolaryngol. 1968;66:515–32.
Sadé J. Retraction pockets and attic cholesteatomas. Acta Otorhinolaryngol Belg. 1980;34:62–84.
Merchant S, Rosowski J, Ravicz M. Middle-ear mechanics of type IV and type V tympanoplasty. II. Clinical analysis and surgical implications. Am J Otol. 1995;16:565–75.
Kurokawa H, Goode RL. Sound pressure gain produced by the human middle ear. Otolaryngol Head Neck Surg. 1995;113(4):349–55.
Spector GJ, Ge XX. Development of the hypotympanum in the human fetus and neonate. Ann Otol Rhinol Laryngol Suppl. 1981;90(6 Pt 2):1–20. https://doi.org/10.1097/MAO.0b013e31822e5b8d.
Noda R. Development of the cerebral vessels of the human fetus [in Japanese]. Fukuoka Acta Med. 1958:1057–72.
Hirakoh G. On the fossa jugularis and outflow cranial venous blood through it [in Japanese]. J Kurume Med Assoc. 1962;25:965–71.
Okudera T, et al. Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol. 1994;15:1871–83.
Park JH, Son SB, Hong HP, Lee HS. A case of jugular bulb diverticulum invading the internal auditory canal. Korean J Audiol. 2012;16:39–42.
Friedmann DR, Eubig J, McGill M, Babb JS, Pramanik BK, Lalwani AK. Development of the jugular bulb: a radiologic study. Otol Neurotol. 2011;32(8):1389–95.
Semaan M, et al. Jugular bulb and skull base pathologies: proposal for a novel classification system for jugular bulb positions and microsurgical implications. Neurosurg Focus. 2018;45(1):E5.
Roland JT Jr, Hoffman RA, Miller PJ, Cohen NL. Retrofacial approach to the hypotympanum. Arch Otolaryngol Head Neck Surg. 1995;121(2):233–6.
Potter GD, Graham MD. The carotid canal. Radiol Clin North Am. 1974;12:483–9.
Hasebe S, Sando I, Orita Y. Proximity of carotid canal wall to tympanic membrane: a human temporal bone study. Laryngoscope. 2003;113(5):802–7.
Brook CD. The prevalence of high-riding jugular bulb in patients with suspected endolymphatic hydrops. J Neurol Surg B Skull Base. 2015;76(6):471–4.
Eby TL. Development of the facial recess: implications for cochlear implantation. Laryngoscope. 1996;106(5 Pt 2 Suppl 80):1–7.
Tóth M. Pre- and postnatal changes in the human tympanic cavity, Semmelweis University School of Doctoral Studies for Developmental Biology Ph.D. Thesis, Budapest; 2007.
Carey JP, Minor LB, Nager GT. Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg. 2000;126(2):137.
Bast TH. Ossification of the otic capsule in human fetuses. Contrib Embryol. 1930;121:53–82.
Sanna M, Fois P, Paolo F, Russo A, Falcioni M. Management of meningoencephalic herniation of the temporal bone: personal experience and literature review. Laryngoscope. 2009;119:1579–85.
De Carpentier J, Axon PR, Hargreaves SP, Gillespie JE, Ramsden RT. Imaging of temporal bone brain hernias: atypical appearances on magnetic resonance imaging. Clin Otolaryngol. 1999;24:328–34.
Toth M, Helling K, Baksa G, Mann W. Localization of congenital tegmen tympani defects. Otol Neurotol. 2007;28:1120–3.
Weber PC. Iatrogenic complications from chronic ear surgery. Otolaryngol Clin North Am. 2005;38:711–22.
Lang J. Skull base and related structures: atlas of clinical anatomy. 2nd ed. Stuttgart: Schattauer; 2001.
Horn KL, Brackman DE, Luxford WM, Shea JJ III. The supratubal recess in cholesteatoma surgery. Ann Otol Rhinol Laryngol. 1986;95:12–5.
Schuknecht HF, Gulya AJ. Anatomy of the temporal bone with surgical implications. Philadelphia: Lea & Febiger; 1986. p. 89–90.
Makki FM, Amoodi HA, van Wijhe RG, Bance M. Anatomic analysis of the mastoid tegmen: slopes and tegmen shape variances. Otol Neurotol. 2011;32(4):581–8.
Minor LB. Superior canal dehiscence syndrome. Am J Otol. 2000;21:9–19.
Ahren C, et al. Lethal intracranial complications following inflation in the external auditory canal in treatment of serous otitis media and due to defects in petrous bone. Acta Otolaryngol (Stockh). 1965;60:407–21.
Lang DV. Macroscopic bony deficiency of the tegmen tympani in adult temporal bones. J Laryngol Otol. 1983;97:685–8.
Nadaraja GS, Gurgel RK, Fischbein NJ, Anglemyer A, Monfared A, Jackler RK. Radiographic evaluation of the tegmen in patients with superior semicircular canal dehiscence. Otol Neurotol. 2012;33:1245–50.
Puwanarajah P, Pretorius P, Bottrill I. Superior semicircular canal dehiscence syndrome: a new aetiology. J Laryngol Otol. 2008;122(7):741–4.
Dubrulle F, Kohler R, Vincent C, Casselman J. Deux cas particuliers de déhiscence du canal semicirculaire supérieur par déhiscence du sinus pétreux supérieur. J Neuroradiol. 2009;36:240–3. https://doi.org/10.1016/j.neurad.2009.02.002.
Tóth M, Medvegy T, Moser G, Patonay L. Development of the protympanum. Ann Anat. 2006;188(3):267–73.
Grand CM, Louryan S, Bank WO, Balériaux D, Brotchi J, Raybaud C. Agenesis of the internal carotid artery and cavernous sinus hypoplasia with contralateral cavernous sinus meningioma. Neuroradiology. 1993;35(8):588–90.
Savic D, Djeric D. Anatomical variations and relations in the medial wall of the bony portion of the eustachian tube. Acta Otolaryngol. 1985;99(5–6):551–6. https://doi.org/10.3109/00016488509182260.
Glastonbury CM, Harnsberger HR, Hudgins PA, Salzman KL. Lateralized petrous internal carotid artery: imaging features and distinction from the aberrant internal carotid artery. Neuroradiology. 2012;54(9):1007–13. https://doi.org/10.1007/s00234-012-1034-8.
PenidoNde O, Borin A, Fukuda Y, Lion CN. Microscopic anatomy of the carotid canal and its relations with cochlea and middle ear. Braz J Otorhinolaryngol. 2005;71(4):410–4.
Young RJ, Shatzkes DR, Babb JS, Lalwani AK. The cochlear-carotid interval: anatomic variation and potential clinical implications. AJNR Am J Neuroradiol. 2006;27(7):1486–90.
Jahrsdoerfer RA. Embryology of the facial nerve. Am J Otol. 1988;9:423–6.
Nager GT, Proctor B. Anatomical variations and anomalies involving the facial canal. Otolaryngol Clin North Am. 1991;24:531–53.
Jahrsdoerfer RA. Congenital absence of the oval window. ORL J Otorhinolaryngol Relat Spec. 1977;84:904–14.
Harada T, Black FO, Sand OI, Singleton GT. Temporal bone histopathologic findings in congenital anomalies of the oval window. Otolaryngol Head Neck Surg. 1980;88:275–87.
Gerhardt HJ, Otto HD. The intratemporal course of the facial nerve and its influence on the development of the ossicular chain. Acta Otolaryngol. 1981;91:567–73.
Lambert PR. Congenital absence of the oval window. Laryngoscope. 1990;100:37–40.
Zeifer B, Sabini P, Sonne J. Congenital absence of the oval window: radiologic diagnosis and associated anomalies. AJNR Am J Neuroradiol. 2000;21(2):322–7.
Cauldwell EW, Anson BJ. Stapes, fissula ante fenestram and associated structures in man. II. From embryos 6.7 to 50 mm in length. Arch Otolaryngol. 1942;36:891–925.
Anson BJ, Cauldwell EW, Bast TH. The fissula ante fenestram of the human otic capsule. II. Aberrant form and contents. Ann Otol Rhinol Laryngol. 1948;57:103–28.
Tóth M, et al. Development and surgical anatomy of the round window niche. Annals of Anatomy - Anatomischer Anzeiger. 2006;188(2):93–101. https://doi.org/10.1016/j.aanat.2005.09.006.
Linder TE, Ma F, Huber A. Round window atresia and its effect on sound transmission. Otol Neurotol. 2003;24(2):259–63.
Djerić D, Savić D. Anatomical characteristics of the fossula fenestrae vestibule. J Laryngol Otol. 1987;101(5):426–31.
Ukkola-Pons E, Ayache D, Pons Y, Ratajczak M, Nioche C, Williams M. Oval window niche height: quantitative evaluation with CT before stapes surgery for otosclerosis. Am J Neuroradiol. 2013;34(5):1082–5.
Anson B, et al. The fissula ante fenestram of the human otic capsule; developmental and normal adult structure. Ann Otol Rhinol Laryngol. 1947;56:957–85.
Toth M, et al. The role of Fissula ante fenestram in unilateral sudden hearing loss. Laryngoscope. 2016;126:2823–6.
Marchioni D, Soloperto D, Colleselli E, Tatti MF, Patel N, Jufas N. Round window chamber and fustis: endoscopic anatomy and surgical implications. Surg Radiol Anat. 2016;38(9):1013–9. Epub 2016 Mar 14.
Chen Y, Yao W. Mechanical model of round window membrane under reverse excitation. Appl Math Mech. 2016;37(10):1341–8. 8p.
Angeli RD, Lavinsky J, Setogutti ET, Lavinsky L. The crista fenestra and its impact on the surgical approach to the scala tympani during cochlear implantation. Audiol Neurotol. 2017;22:50–5.
Atturo F, Barbara M, Rask-Andersen H. On the anatomy of the ‘hook’ region of the human cochlea and how it relates to cochlear implantation. Audiol Neurootol. 2014;19(6):378–85.
Li PM, Wang H, Northrop C, Merchant SN, Nadol JB Jr. Anatomy of the round window and hook region of the cochlea with implications for cochlear implantation and other endocochlear surgical procedures. Otol Neurotol. 2007;28(5):641–8.
Carpenter A-M, Muchow D, Goycoolea MV. Ultrastructural studies of the human round window membrane. Arch Otolaryngol Head Neck Surg. 1989;115(5):585–90. https://doi.org/10.1001/archotol.1989.01860290043012.
Fugita, et al. Otol Neurotol xx:xx (c) 2016.
Rask-Andersen H, Liu W, Erixon E, Kinnefors A, Pfaller K, Schrott-Fischer A, Glueckert R. Human cochlea: anatomical characteristics and their relevance for cochlear implantation. Anat Rec. 2012;295:1791–811.
Kim M, Yang WS, Jeon JH, Choi JY. Electrode misdirection into the superior semicircular canal: complication of cochlear implantation by round window approach. Int Adv Otol. 2014;10(3):246–50.
Goycoolea MV, Muchow DD, Sirvio LM, Winandy RM, Canafax DM, Hueb M. Extended middle ear drug delivery. Acta Otolaryngol Suppl. 1992;493:119–26.
Mansour S, Nicolas K, Ahmad HH. Round window otosclerosis: radiologic classification and clinical correlations. Otol Neurotol. 2011;32(3):384–92.
Goycoolea MV, Muchow D, Schachern P. Experimental studies on round window structure: function and permeability. Laryngoscope. 1988;98(6 Pt 2 Suppl 44):1–20.
Kim CS, Cho TK, Jinn TH. Permeability of the round window membrane to horseradish peroxidase in experimental otitis media. Otolaryngol Head Neck Surg. 1990;103:918–25.
Penha R, Escada P. Round-window anatomical considerations in intratympanic drug therapy for inner-ear diseases. Int Tinnitus J. 2005;11(1):31–3.
Mancheño M, Aristegui M, Sañudo JR. Round and oval window anatomic variability: its implications. Otol Neurotol. 2017;38(5):e50–7.
Tringali S, Koka K, Deveze A, Holland NJ, Jenkins HA, Tollin DJ. Round window membrane implantation with an active middle ear implant: a study of the effects on the performance of round window exposure and transducer tip diameter in human cadaveric temporal bones. Audiol Neurootol. 2010;15(5):291–302.
Gopen Q, Rosowski JJ, Merchant SN. Anatomy of the normal human cochlear aqueduct with functional implications. Hear Res. 1997;107(1–2):9–22.
Ghiz AF, et al. Quantitative anatomy of the round window and cochlear aqueduct in guinea pigs. Hear Res. 2002;162(1–2):105–12. https://doi.org/10.1016/S0378-5955(01)00375-6. Source: PubMed.
Anson BJ, Donaldson JA, Warpeha RL, Winch TR. The vestibular and cochlear aqueducts: their variational anatomy in the adult human ear. Laryngoscope. 1965;75(8):1203–23.
Park TS, Hoffman HJ, Humphreys RP, Chuang SH. Spontaneous cerebrospinal fluid otorrhea in association with a congenital defect of the cochlear aqueduct and Mondini dysplasia. Neurosurgery. 1982;11(3):356–62.
Carlborg BIR, Farmer JC Jr. Transmission of cerebrospinal fluid pressure via the cochlear aqueduct and endolymphatic sac. Am J Otolaryngol Head Neck Med Surg. 1983;4(4):273–82.
Bianchin G, et al. Cerebrospinal fluid leak in cochlear implantation: enlarged cochlear versus enlarged vestibular aqueduct (common cavity excluded). Int J Otolaryngol. 2016;2016:6591684. https://doi.org/10.1155/2016/6591684. 9 pages.
Stimmer H. Enlargement of the cochlear aqueduct: does it exist? Eur Arch Otorhinolaryngol. 2011;268(11):1655–61.
Leuwer RM, Westhofen M. Surgical anatomy of the singular nerve. Acta Otolaryngol. 1996;116(4):576–80.
Leveque M, Labrousse M, Seidermann L, Chays A. Surgical therapy in intractable benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2007;136:693–8. Review.
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Mansour, S., Magnan, J., Ahmad, H.H., Nicolas, K., Louryan, S. (2019). Middle Ear Cavity. In: Comprehensive and Clinical Anatomy of the Middle Ear. Springer, Cham. https://doi.org/10.1007/978-3-030-15363-2_2
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