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Color Atlas of the Anatomy and
Pathology of the Epitympanum
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copy/ies: Palva, T.; Ramsay, H.; Northrop, C.
Color Atlas of the Anatomy and Pathology
of the Epitympanum
CHF 257.– / EUR 170.77 / USD 223.50
ISBN 3–8055–7227–1
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Karger Journals in
Oto-Rhino-
Laryngology
S. Karger
Medical and Scientific
Publishers
Basel � Freiburg
Paris � London
New York � New Delhi
Bangkok � Singapore
Tokyo � Sydney
Basic Research and
Clinical Applications
Europäische Zeitschrift für Praxis,
Klinik und Forschung
63 t 3 t 01
May–June 2001
Journal for Oto-Rhino-Laryngology
and Its Related Specialties
Journal européen pour la pratique, European Journal for the Practitioner,
la clinique et la recherche
Clinician and Researcher
Original Papers • Travaux originaux Originalarbeiten
183 External Auditory Canal Measurements: Localization of the Isthmus
Bestimmung des Isthmus des äusseren Gehörganges anhand von Messungen
Mesures du conduit auditif externe: localisation de l’isthme
Ahmad, I.; Lee, W.C.; Binnington, J.D. (Dudley)
187 Akute Mastoiditis im Kindesalter. Retrospektivstudie 1979–1998
Acute Mastoiditis in Children: Retrospective Study 1979–1998
Mastoïdite aiguë de l’enfant: étude rétrospective 1979–1998
Mross, C.; Klemm, E. (Dresden)
194 TEOAE-Messungen zur Verlaufsbeurteilung akuter kochleovestibulärer
Störungen: methodische Aspekte
TEOAE Measurements in the Assessment of the Course of Acute
Cochleovestivular Disturbances: Methodological Aspects
Mesure des TEOAE pour la prédiction de l’évolution de troubles
cochléovestibulaires aigus: aspects méthodologiques
Nölle, C.; Wunder, M.; Ernst, A. (Berlin)
204 Large Vestibular Aqueduct Syndrome Presenting with Mixed Hearing Loss and
an Intact Mobile Ossicular Chain
Das Syndrom des grossen vestibulären Aquädukts mit kombinierter
Schallleitungs- und Schallempfindungsschwerhörigkeit
Déficit auditif mixte et chaîne ossiculaire intacte comme manifestation d’un
aqueduc vestibulaire large
Mam}kogElu, B. (Evanston, Ill.); Bentz, B. (Chicago, Ill.); Wiet, R.J. (Evanston, Ill.)
207 Der Einfluss von druckinduzierten Trommelfellbewegungen auf vestibulospinale
und vestibulookuläre Reaktionen bei Patienten mit Morbus Ménière
The Influence of Pressure-Induced Ear Drum Movements on Vestibular Reactions
in Patients Suffering from Ménière’s Disease
Influence des mouvements du tympan liés aux variations de pression sur les
réactions vestibulo-spinales et vestibulo-oculaires de patients souffrant de la
maladie de Ménière
Petzold, T.; Hüttenbrink, K.-B.; Dörr, C. (Dresden)
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‘Audiology and Neuro-
Otology’ provides a forum
for the presentation of
outstanding papers on the
auditory and vestibular
systems. It aspires to promote
an active and stimulating
exchange of ideas
between basic and clinical
disciplines.
Covering both basic and
clinical research on the
anatomy, pathology, pathophysiology,
immunology
and tumor biology of
the auditory and vestibular
system and of the upper
respiratory and digestive
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Promoting an exchange
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of Europe and encouraging
mutual understanding on
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issues.
KP 01115 (16.07.01) Printed in Switzerland (1.24, 1.02)
A guide through middle ear compartments
Color Atlas
of the Anatomy and
Pathology of the
Epitympanum
T. Palva
In collaboration with
H. Ramsay
C.Northrop

Color Atlas
of the Anatomy and
Pathology of the
Epitympanum
Color Atlas
of the Anatomy and
Pathology of the
Epitympanum
T. Palva
In collaboration with
H. Ramsay
C.Northrop
Palva, T. (Helsinki); Ramsay, H. (Helsinki);
Northrop, C. (Boston, Mass.)
Color Atlas of the Anatomy and
Pathology of the Epitympanum
X + 104 p., 171 fig., 166 in color,
hard cover, 2001
CHF 257.– / EUR 170.77 / USD 223.50
ISBN 3–8055–7227–1
Prices subject to change
EUR price for Germany,
USD price for USA only
This Atlas gives a detailed documentation
of the superior compartments
of the middle ear. New microdissection
approaches have been developed, most importantly
anterior microdissection. In addition to the tympanic
cavity, this approach allows a direct view into the
anterior membrane of Prussak’s space, the anterior surface of
the tensor fold, and the supratubal recess, areas not explored
earlier. The regular and hitherto unknown auxiliary aeration
and drainage pathways are shown in detail. Aeration of Prussak’s
space is documented using both microdissection and serial sections;
these pathways from the mesotympanum or from the lower
lateral attic are independent of the tympanic isthmus. The pathology
caused by chronic inflammation on the aeration and drainage
routes is also documented, and new surgical microdissection methods
for removal of the tensor fold are described.
This Atlas is invaluable in the temporal bone laboratory for all
residents learning anatomy and pathology of the middle ear compartments,
and for the experienced otologist the photographic documentation
gives reliable evidence of the variable structures in the
epitympanic compartments.
Fields of Interest: Otorhinolaryngology,
Audiology, Histology,
Pathology, Pediatrics
Contents
Preface
Part 1: Anatomy and Pathology of the
Epitympanum
Introduction and General Review
� Development of the concept of epitympanum
� Early data of the soft tissues in the epitympanum
� Fetal development of epitympanic folds and
compartments
Tensor Fold � Lateral Incudomalleal Fold �
Chordal Fold � Other Duplicate Folds �
Tympanic Isthmus � Development of Prussak’s
Space
� Contemporary Concepts of the Anatomy of the
Epitympanum
Material and Methods
Anatomy and Pathology of the Epitympanum and
Supratubal Recess
� Epitympanic Diaphragm
� Normal Anatomy of Prussak’s Space (with the
Lateral Malleal Space)
Microdissection � Serial Sections
� Pathology of Prussak’s Space and the Lateral
Malleal Space
Microdissection � Serial Sections
� Cholesteatoma in Prussak’s Space
� Large Epitympanic Compartments
Posterior Epitympanum � Anterior Epitympanum
� Supratubal Recess (Space)
References
Part 2: Pathology Related to Amniotic Fluid
Cellular Content and Superimposed Infection
Introduction and Short Review of the Literature on
Amniotic Fluid Cellular Content
Short Review of Mastoid Pneumatization
Amniotic Fluid Cellular Content-Related Middle
Ear Pathology as a Function of Age in Serial
Sections
� Temporal Bones from Neonates
Superior and Anterior Epitympanum and
Antrum � Tensor Fold and Supratubal
Recess � Lateral Incudomalleal Fold and
Lateral Attics � Lateral Malleal Space and
Prussak’s Space � Medial Attic and Tympanic
Isthmus � Tympanic Cavity � Eustachian Tube �
Mastoid Pneumatization � Comment
� Temporal Bones from 2- to 4-Month-Old Infants
Compartments above the Epitympanic
Diaphragm and the Mastoid Antrum � Tensor
Fold and Supratubal Recess � Lateral Malleal
Space and Lateral Attics � Prussak’s Space and
Its Aeration Pathways � Tympanic Isthmus and
Posterior Tympanum � Tympanic Sinus and
Round Window Niche � Eustachian Tube �
Elements Specific to Amniotic Fluid Cellular
Content � Mastoid Pneumatization � Comment
� Temporal Bones from 5- to 23-Month-Old Infants
Case 1 � Case 2 � Case 3 � Case 4 � Case 5 �
Elements Specific to Amniotic Fluid Cellular
Content � Mastoid Pneumatization � Comment
General Comments
� Histological Considerations regarding Amniotic
Fluid Cellular Content- Associated Pathology
� Mastoid Pneumatization
� Clinical Considerations
References
Part 3: Microsurgical Approaches to
Inflammatory Ear Disease
Introduction
Early Attempts to Improve Epitympanic Aeration
Microsurgical Methods in Surgery for Retraction
Pockets
� Surgery for Incipient Retraction Pocket
� Surgery for Established Retraction Pockets
Frontolateral Atticotomy
� Extensive Attic and Mesotympanic Disease in
Chronic Otitis media
Spread of Cholesteatoma from Prussak’s Space
� Posterior Route
� Inferior Central Route
� Superior Route
� Anterior Route
Final Remarks
References
Subject Index