In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery

Abstract Objective The middle ear has compartments with the presence of anatomic variations. Transcanal endoscopic middle ear surgery facilitates the exploration of every single compartment with the least possible tissue dissection. Methods This study was conducted on 250 middle ears of patients who...

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Main Authors: Waleed Moneir, Fatema Alzahraa Ibraheem, Hesham Mohamed Eladl, Mohamed Elshaer, Yasser Khafagy, Mohamed Elkahwagi
Format: Article
Language:English
Published: SpringerOpen 2023-11-01
Series:The Egyptian Journal of Otolaryngology
Subjects:
Online Access:https://doi.org/10.1186/s43163-023-00545-6
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author Waleed Moneir
Fatema Alzahraa Ibraheem
Hesham Mohamed Eladl
Mohamed Elshaer
Yasser Khafagy
Mohamed Elkahwagi
author_facet Waleed Moneir
Fatema Alzahraa Ibraheem
Hesham Mohamed Eladl
Mohamed Elshaer
Yasser Khafagy
Mohamed Elkahwagi
author_sort Waleed Moneir
collection DOAJ
description Abstract Objective The middle ear has compartments with the presence of anatomic variations. Transcanal endoscopic middle ear surgery facilitates the exploration of every single compartment with the least possible tissue dissection. Methods This study was conducted on 250 middle ears of patients who had endoscopic ear surgery (tympanoplasty and stapedotomy) at the period of the study with endoscopic recording of the data. Intraoperative examination of the pro, retro, and hypotympanum was performed with 0, 30, and 45° endoscopes and data was collected, processed, and analyzed with Statistical Package for Social Sciences (SPSS). Results Quadrangular conformation (64%), type B (shallow subtensor recess) (64.8%), and type A protinuculum (ridge) were the commonest in the protympanum. Type A jugular bulb which lies below the level of the bony annulus was the commonest finding (75.6%) in the hypotympanum. Type A (ridge) variant was the commonest finding of ponticulus, subiculum, and finiculus 88.4%, 64.8%, and 72.8% respectively in the retrotympanum. Type B (deep) ST 53.6% was the commonest regarding sinus tympani. Type A (present) subcochlear canaliculus, type B (oblique) fustis and type B (absent) RW membrane were the most common regarding the round window region. Conclusion Good knowledge of the anatomical variations of the middle ear has great surgical importance. The study showed variations of the known structures from other studies that can be attributed to being an in vivo study, racial differences, and a larger sample size.
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spelling doaj.art-69155712a6fc4f1180e6fd1c31f404d52023-11-26T12:10:43ZengSpringerOpenThe Egyptian Journal of Otolaryngology2090-85392023-11-013911810.1186/s43163-023-00545-6In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgeryWaleed Moneir0Fatema Alzahraa Ibraheem1Hesham Mohamed Eladl2Mohamed Elshaer3Yasser Khafagy4Mohamed Elkahwagi5Mansoura University, Otorhinolaryngology departmentMansoura general hospitalMansoura University, Otorhinolaryngology departmentMansoura University, Otorhinolaryngology departmentMansoura University, Otorhinolaryngology departmentMansoura University, Otorhinolaryngology departmentAbstract Objective The middle ear has compartments with the presence of anatomic variations. Transcanal endoscopic middle ear surgery facilitates the exploration of every single compartment with the least possible tissue dissection. Methods This study was conducted on 250 middle ears of patients who had endoscopic ear surgery (tympanoplasty and stapedotomy) at the period of the study with endoscopic recording of the data. Intraoperative examination of the pro, retro, and hypotympanum was performed with 0, 30, and 45° endoscopes and data was collected, processed, and analyzed with Statistical Package for Social Sciences (SPSS). Results Quadrangular conformation (64%), type B (shallow subtensor recess) (64.8%), and type A protinuculum (ridge) were the commonest in the protympanum. Type A jugular bulb which lies below the level of the bony annulus was the commonest finding (75.6%) in the hypotympanum. Type A (ridge) variant was the commonest finding of ponticulus, subiculum, and finiculus 88.4%, 64.8%, and 72.8% respectively in the retrotympanum. Type B (deep) ST 53.6% was the commonest regarding sinus tympani. Type A (present) subcochlear canaliculus, type B (oblique) fustis and type B (absent) RW membrane were the most common regarding the round window region. Conclusion Good knowledge of the anatomical variations of the middle ear has great surgical importance. The study showed variations of the known structures from other studies that can be attributed to being an in vivo study, racial differences, and a larger sample size.https://doi.org/10.1186/s43163-023-00545-6Middle earEndoscopic ear surgeryRetrotympanumHypotympanumProtympanumHidden spaces
spellingShingle Waleed Moneir
Fatema Alzahraa Ibraheem
Hesham Mohamed Eladl
Mohamed Elshaer
Yasser Khafagy
Mohamed Elkahwagi
In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
The Egyptian Journal of Otolaryngology
Middle ear
Endoscopic ear surgery
Retrotympanum
Hypotympanum
Protympanum
Hidden spaces
title In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
title_full In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
title_fullStr In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
title_full_unstemmed In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
title_short In vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
title_sort in vivo endoscopic study of the variations of anatomical structures in the hidden spaces of the middle ear during endoscopic ear surgery
topic Middle ear
Endoscopic ear surgery
Retrotympanum
Hypotympanum
Protympanum
Hidden spaces
url https://doi.org/10.1186/s43163-023-00545-6
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