The posterosuperior quadrant of the tympanic membrane

Otolaryngology - Head and Neck Surgery - Tập 140 - Trang 884-888 - 2009
João Paço1, Carla Branco1, Hugo Estibeiro1, Diogo Oliveira e Carmo1
1Hospital Cuf Infanto Santo, Lisbon, Lisbon, Portugal

Tóm tắt

Objective

To document the anatomic relationship of the posterosuperior segment of the tympanic membrane.

Study Design

Point‐prevalence study of postmortem material.

Subjects and Materials

One hundred seventy temporal bones from adults without history of otologic pathology were studied. The anatomic details of the tympanic membrane were observed, histology was documented on 30 sectioned bones, and, with the use of the scanning electron microscope, lamina propria was studied in 40 bones.

Results

We established that the posterosuperior quadrant was the largest, representing 28.7 percent of the total area of the eardrum. This feature implies that this quadrant is more likely than are the other quadrants to exhibit changes prompted by pressure challenges. We also verified that the posterosuperior part of tympanic sulcus, above the chorda tympanic nerve, lost its depth in an unexpected way in 60 percent of the cases. In association, we established that at this level there was a decrease in annulus caliber. In 25 percent of cases, by the absence of the circular fibers of lamina propria, the posterosuperior quadrant had only the radial fiber layer.

Conclusions

Anatomic and morphologic details in posterosuperior quadrant were newly described and may explain the greater incidence of retraction pockets and marginal perforations that provide origin for the cholesteatoma.


Tài liệu tham khảo

Shrapnell HJ, 1832, On the form and structure of the membrane timpani., London Med Gazette, 10, 120 Ars B, 1986, Lamina propria and Tympanic retractions—morphological and physical details., Les Cahiers d'ORL AmiriC.Hypothesis based on anatomical aberration and certain conditions responsible for cholesteatoma formation.In: Cholesteatoma First International Conference 1977 10.1177/000348946907800509 Testu L, 1949, Principles of human anatomy., 730 10.3109/00016486809126286 Kirikae I, 1960, The structure and function of the middle ear. Ars B, 1884, Tympanic membrane morphogenesis., Acta Otorhinolaringol Belg, 38, 227