The Epitympanum Revisited: Endoscopic Anatomy

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In contrast to other means of studying the epitymapnum, the endoscope allows unparallel access without disruption of anatomy. The aim of this study is to delineate the anatomy of the epitympanum through transcanal endoscopy. Systematic dissection of anatomic specimens. We performed systematic endoscopic dissection of 20 ears in 10 fresh frozen anatomical specimens. A detailed flow sheet was filled up documenting the status of the lateral attic folds, the tensor fold, the cog and the tensor folds, the supratubal recess, and the patency of the anterior and posterior isthmus. None of the ears showed indication of previous chronic otitis media. The lateral incudomallear fold was intact in all but one ear. The lateral mallear fold was intact in all specimens. The tensor fold was complete in 16 ears and partial in four. Two of these ears belonged to the same specimen. The epitympanic diaphragm was complete in 15 out of 20 ears in 10 anatomic specimens. The endoscope allows for assessment of the attic anatomy and integrity of the diaphragm without undue disruption of anatomy. The epitympanic diaphragm is present in the majority of healthy ears and can in theory serve as the anatomic basis for the isolated attic retraction.