The Endoscopic Anatomy of Temporal Bone

Abstract

The endoscopic middle ear surgery has evolved over the time course. The usage of the endoscope in middle ear surgery gave a wider and clearer anatomy of middle ear spaces due to a better magnification and to the possibility to look into the hidden spaces. The hidden recesses most likely to cause an undetected residual and recurrence are the sinus tympani, the anterior epitympanic space, and the protympanic spaces can now be explored with a good magnification. This advantage enables us to perform a less invasive and more physiologic surgery of middle ear. This chapter gives a detailed description of the endoscopic middle ear anatomy with description of every compartment, with particular attention to ventilation pathways and middle ear folds. The trans canal access to the tympanic cavity with the endoscope and it is hard to reach extensions have given us the privilege to divert the attention from the less critical area like the mastoid proper to the tympanic cavity (Baki et al., Otolaryngol Head Neck Surg 127:158–162, 2002; Thomassin et al., Laryngoscope 103:939–943, 1993; Badr-El-Dine, Otol Neurotol 23:631–635, 2002; Tarabichi, Am J Otol 18:544–549, 1997; Tarabichi, Laryngoscope 114:1157–1162, 2004; Bowdler and Walsh, Clin Otolaryngol Allied Sci 20:418–422, 1995; Bottril and Poe Am J Otol 16:158–163, 1995; Karhuketo et al., Acta Otolaryngol Suppl 529:34–39, 1997).