Anatomic Limitations of Posterior Exposure of the Sinus Tympani

Aslan, Asım; Guclu, Gulay; Tekdemi̇r, İbrahi̇m; Elhan, Alai̇tti̇n

doi:10.1016/j.otohns.2004.03.028

Cited by 8 publications

(5 citation statements)

References 11 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The surgical access to sinus tympani may be challenging, because of the localization of the facial nerve and the stapedial muscle with its tendon [ 2 ].…”

Section: Resultsmentioning

confidence: 99%

“…Sinus tympani (ST) is considered to be largest space in the retrotympanum. It is located medially to the pyramidal eminence, stapedius muscle, and facial nerve and laterally to the posterior semicircular canal [ 2 , 15 , 26 ]. The morphology varies among individuals, although factors affecting the variations in size and shape are unclear.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

et al. 2021

View full text Add to dashboard Cite

Purpose Sinus tympani is the space in the retrotympanum, with variable morphology. Computed tomography is a common tool to investigate sinus tympani anatomy. During cochlear implantation or tympanoplasty, electrocochleography can be used for hearing monitoring. In such a surgical strategy the electrode is placed in the round window’s region throughout posterior tympanotomy. Common accessible needle-shaped electrodes using is difficult in achieving intraoperative stabilization. The aim of the study is to assess the dimensions and shape of sinus tympani, basing on the micro computed tomography scans for purposes of establishing the possible new electrocochleography electrode shape. Materials and methods Sixteen fresh frozen cadaveric temporal bones were dissected. MicroCT measurements included the depth and the width of sinus tympani, width of facial canal with stapedius muscle chamber. Obtained data were analyzed statistically with the use of RStudio 1.3.959 software. Results The highest average width of sinus tympani amounted for 2.68 mm, depth measured at the round window plane for 3.19 mm. Width of facial canal with stapedius muscle chamber highest average values at the round window plane- 3.32 mm. The lowest average minimum and maximum values were calculated at the 1 mm above the round window plane. The highest average posterior tympanotomy width was 2.91 mm. Conclusions The shape of the tympanic sinus is like a trough with the narrowest and deepest dimensions in the middle part. The ST shape and dimensions should be taken into account in constructing the ECochG electrode, designed for optimal placement through posterior tympanotomy approach.

show abstract

“…The surgical access to sinus tympani may be challenging, because of the localization of the facial nerve and the stapedial muscle with its tendon [ 2 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Pickett et al [ 1 ] analyzed STs in computed tomography, writing about the "luxury" that aural surgeons have at their disposal by planning operations based on images obtained with this method. Further researchers have demonstrated one bone specimens the possibility of accessing the deep portion of the ST through the mastoid cells [ 17 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Sinus tympani revisited for planning retrofacial approach—radiologic study in pneumatized temporal bones and its surgical implications

Wojciechowski

Bartoszewicz

Szopiński

2022

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Background and purpose Retrofacial approach (RFA) is an access route to sinus tympani (ST) and it is used in cholesteatoma surgery, especially when type C ST is encountered. It may also be used to gain an access to stapedius muscle to assess the evoked stapedius reflex threshold. The primary object of this study was to evaluate the morphology of sinus tympani and its relationship to facial nerve (FN) and posterior semicircular canal (PSC) in context of planning retrofacial approach in pneumatized temporal bones. Methods CBCT of 130 adults were reviewed. The type of sinus tympani was assessed according to Marchioni's classification. Width of entrance to sinus tympani (STW), depth of ST (STD), distance between the posterior semicircular canal and facial nerve (F-PSC), distance between the latter plane to the floor of ST at the right angle (P-ST) were measured at level of round window (RW) and pyramidal ridge (PR). Results All of the bones were well-aerated and classified in Dexian Tan pneumatization group 3 or 4. Type B of ST is dominant (70.8%) in adult population with no history of inflammatory otologic diseases, followed by type C (22.7%) and then type A (6.5%). The depth of ST (STD) presented significant deviations (ANOVA, p < 0.05) among all three types. STW reaches greater values on the level of PR. F-PSC does not correlate with type of ST. In over 75% of examined type C sinus tympani the distance P-ST was less than 1 mm. Conclusions The qualitative classification of the sinus tympani into types A, B and C, introduced by Marchioni is justified by statistically significant differences of depth between individual types of tympanic sinuses. The STW distance reaches greater values inferiorly—it may suggest that RFA should be performed in infero-superior manner rather than opposite direction. Preoperative assessment of temporal bones CT scans gives very important information about size of sinus tympani and distance between FN and PSC.

show abstract

“…This anatomical space was first described by Meckel in 182017 with particular regard to the SS and the PE, and then Steinbrugge reviewed the anatomy in 1889 describing the depth of the ST 18. In 1960, Dworacek19 first used the operating microscope to improve visualization of this space, and subsequently Proctor, Donaldson, and others added further surgical anatomical studies based on anatomical dissection of fetal, infant and adult temporal bones 1, 20, 21. The retrotympanum houses four sinuses located around the bony canal of the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

Pyramidal eminence and subpyramidal space: An endoscopic anatomical study

et al. 2009

View full text Add to dashboard Cite

show abstract

Anatomic Limitations of Posterior Exposure of the Sinus Tympani

Abstract: It is possible to expose the sinus tympani from the posterior by careful dissection through this triangle, which has almost constant dimensions.

Cited by 8 publications

References 11 publications

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

Sinus tympani revisited for planning retrofacial approach—radiologic study in pneumatized temporal bones and its surgical implications

Pyramidal eminence and subpyramidal space: An endoscopic anatomical study

Contact Info

Product

Resources

About