By T. Palva
This atlas supplies an in depth documentation of some of the best cubicles of the center ear. New microdissection methods were constructed, most significantly anterior microdissection. as well as the tympanic hollow space, this procedure permits a right away view into the anterior membrane of Prussak's house, the anterior floor of the tensor fold, and the supratubal recess, components no longer explored past. The average and hitherto unknown auxiliary aeration and drainage pathways are proven intimately. Aeration of Prussak's area is documented utilizing either microdissection and serial sections; those pathways from the mesotympanum or from the reduce lateral attic are self sufficient of the tympanic isthmus. The pathology attributable to persistent irritation at the aeration and drainage routes is additionally documented, and new surgical microdissection tools for removing of the tensor fold are defined.
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Extra info for Colour Atlas of the Anatomy and Pathology of the Epitympanum
L = Lateral malleal space, A = anterior malleal ligamental fold; C = chorda tympani nerve. 34 Fig. 49. Series P, case 12, a child aged 6 years, left ear, superior view. This patient had a tympanostomy tube in place with a clinically symptomless mesotympanum. There was thick mucus in the epitympanum, after suctioning small cholesterol cysts (oblique arrows) remain on the tip of the incus (I) and on the head of the malleus (M). The lateral incudomalleal fold is thin (horizontal arrow). A multilayered inflammatory network (curved arrows) closes the major portion of the tympanic isthmus, the small remaining open area did not allow outflow of the sticky secretion.
12. Fig. 68. Series A, adult case 12, left ear, superoposterior view. Thick mucosa and granulation tissue mask the details of the anterior attic. Vertical arrow points to the area of the tensor fold covered by granulation tissue and webs, horizontal arrow to the place of the tensor tendon. There is similar tissue on top of the lateral malleal space (oblique arrow). M = Malleus. Fig. 69. Series A, adult case 15, left ear, superior view. a The anterior attic is full of immature granulation tissue and no details can be discerned.
In adults the distance from the anterior portion of the head of the malleus to the tip of the incus is around 8 mm. The malleus head is superiorly close to the attic roof but from the tip of the incus the distance is larger, around 6 mm. The lateral portion of the posterior epitympanum is narrower and the thin incudomalleal fold divides it into two separate compartments which overlie each other. The lower lateral attic, between the short process and the body of the incus, and the lateral attic wall are thus below the epitympanic diaphragm and go over to the mesotympanic 28 Normal Anatomy by Microdissection Superior microdissection is by far the best method for getting an idea of the normal subcompartments within the posterior epitympanum because it gives at one glance a 3-dimensional view of all spaces and structures.