A postauricular incision is more appropriate for excising small, discrete lesions of the anterior mesotympanum or when mastoidectomy is anticipated for tumors that extend to the
epitympanum, hypotympanum, or outside the middle ear space.
(c) (10x)
Epitympanum showing ganglion cells (arrow).
The lesion, although extensive, also seemed to arise from the
epitympanum. Tegmen tympani and lateral semi-circular wall dehiscence were also visible (Fig.
This exposure were also enough for C1a (Lateral
epitympanum and Prussak's space lesions), C2b (Mesotympanum, Protympanum, sinus tympani and Hypotympanum cholesteatomas), C2c (Posterior and inferior extensions) lesions and C3 cholesteatoma involving retrotympanic space (Sinus tympani/subtympanic sinus; subpyramidal space) and or with facial nerve involvement.
Less commonly, there was immobilization of the first and second ossicles (fixation in the
epitympanum), bony callus covering the body of the incus and the lateral semi-circular canal, and exposure of the tympanic segment of the facial nerve overlying the stapes footplate.
We removed the tumor by dissecting the temporal bone from the mastoid to the
epitympanum. We removed the granulation tissue in the
epitympanum.
Subsequent MRI and computed tomography (CT) demonstrated a destructive right petrous apex lesion with extension into the carotid canal and the medial
epitympanum up to the Meckel cave.
Middle ear osteomas (MEOs) are benign lesions arising from the bony structures of the middle ear and
epitympanum [3].
Epitympanic (Attic) cholesteatomas arise in the pars flaccida and grow upwards towards the
epitympanum. These may be subdivided into lateral epitympanic cholesteatomas if they involve only the Prussak's space, posterior epitympanic cholesteatomas if they grow medial to the incus to involve the posterior epitympanic space, anterior epitympanic cholesteatoma if they grow anteriorly to fill the space anterior to the cog.
There was also nondependent soft tissue abutting the posterior middle ear and extending into the
epitympanum, with marked erosion of the incus body.
Partial scutum removal to create only a window at the scutum (for access to the
epitympanum)while preserving its inferior border is also to be classified as [M.sub.2a].
In early stages, it was used to provide information regarding pathology in the
epitympanum, mesotympanum and mastoid antrum and to check the assessment of ossicular chain mobility.