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Updated: Feb 9, 2026
10:40
Discovering Middle Ear Anatomy by Transcanal Endoscopic Ear Surgery: A Dissection Manual
Published on: January 11, 2018
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The protympanum, protiniculum and subtensor recess: an endoscopic morphological anatomy study
N Jufas1, A Rubini2, D Soloperto2
1Kolling Deafness Research Centre,Royal North Shore Hospital and Macquarie University,Sydney,Australia.
The Journal of Laryngology and Otology
|June 12, 2018
Summary
Endoscopic visualization reveals protympanum anatomy and variations. This detailed knowledge of the protympanum, protiniculum, and subtensor recess is crucial for safe middle ear surgery.
Area of Science:
- Otolaryngology
- Surgical Anatomy
- Endoscopic Ear Surgery
Background:
- The protympanum, an often overlooked middle ear region, presents visualization challenges with traditional microscopy.
- Advancements in endoscopic technology now allow for detailed anatomical study of this area.
Purpose of the Study:
- To describe the endoscopic anatomy and variations of the protympanum.
- To classify the protiniculum and subtensor recess based on endoscopic findings.
Main Methods:
- Retrospective review of video recordings from cadaveric dissections and endoscopic ear surgeries.
- Analysis of 97 ears across four tertiary university referral centers over 16 months.
Main Results:
- Quadrangular protympanum conformation observed in 60% of cases; triangular in 40%.
- Protiniculum types: Type A (ridge) in 58%, Type B (bridge) in 23%, Type C (absent) in 19%.
- Subtensor recess types: Type A (absent) in 30%, Type B (shallow) in 48%, Type C (deep) in 22%.
Conclusions:
- Endoscopic visualization provides critical anatomical insights into the protympanum.
- This detailed knowledge is fundamental for enhancing the safety of endoscopic surgical procedures in the middle ear.
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