ANTERIOR EPITYMPANIC RECESS; ANATOMICAL AND OPERATIVE STUDY IN CHOLESTEATOMA

Abstract

The anatomy of the anterior epitympanic recess is complex and relatively unfamiliar to the surgeon. There are great variations of the anterior epitympanic recess structural anatomy. These variations in its structure and its close relationships with a number of vital structures such as the facial nerve, cochlea, carotid artery and middle fossa dura must be taken into consideration during the surgical management of middle ear disease. The present study was performed to study the anatomy of the anterior epitympanic space and to describe the variations in its shape and anatomical structures related to it, and to emphasize its importance in cholesteatoma surgery. The current work was conducted on twenty temporal bones of cadaveric specimens obtained from the Anatomy Department, Faculty of Medicine, Alexandria University and thirty patients with cholesteatomatous ear had undergone operation for checking the invasion of the anterior epitympanic space by cholesteatoma. After initial bony preparation, the anatomical study was carried out via the transmastoid approach in all the specimens whereas in the last five specimens the anterior dissection approach was added to the study.