By T. Palva

This atlas supplies a close 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 strategy permits an immediate view into the anterior membrane of Prussak's area, the anterior floor of the tensor fold, and the supratubal recess, components no longer explored prior. The usual 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 decrease lateral attic are self reliant of the tympanic isthmus. The pathology as a result of power irritation at the aeration and drainage routes can be documented, and new surgical microdissection equipment for removing of the tensor fold are defined.

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Additional resources for Colour Atlas of the Anatomy and Pathology of the Epitympanum

Example text

The tympanic isthmus (TI) is fully open. M = Malleus; I = incus; A = anterior malleal ligamental fold. posterior edge of the malleus head (fig. 33). Here it regularly turns downwards to become united with the posterior malleal ligamental fold, forming with it the posterior border of the lateral malleal space (fig. 34), closing completely the lower lateral attic. At times 1 or 2 stronger transverse bundles cross the fold allowing a slight change in its horizontal orientation (fig. 35). In some ears it courses inferiorly along the low border of the incus directly to the posterior malleal ligamental fold (fig.

Superior Malleal Ligamental Fold. The head of the malleus is fastened superiorly to the attic roof by a narrow ligament. In the fetal process of the aeration of the epitympanum, the anteriorly advancing medial air sac, when passing this structure, leaves a trailing fold. It is generally thin and short and only occasionally may extend forward to the attic roof in front of the head of the malleus, and mostly it is absent (fig. 43). The elaborate superior malleal and incudal sagittal and frontal folds included in the sketches of Proctor [13, 14], and reproduced by Wullstein and Wullstein [11], are pure fantasy in normal ears.

The lower lateral attic (curved arrow) communicates freely with the upper lateral attic. A small area of the lateral malleal space (oblique arrow) appears lateral to the malleus (M). TI = Tympanic isthmus. Fig. 40. Series G, adult case 16, left ear, superior view. An auxiliary aeration pathway (vertical arrow) via the incudal fossa appears posterior to the tip of the incus short process (I). Application of a suction tip to this opening emptied rapidly the tympanic cavity filled with water. An oblique arrow points to the tympanic isthmus, a curved arrow to the lateral incudomalleal fold.

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