Tensor fold and anterior epitympanum

Area of Science:

• Otolaryngology
• Anatomy
• Pathology

Background:

• Conflicting contemporary reports exist regarding the anterior epitympanum and tensor fold.
• Previous studies offer relevant data, but some concepts are erroneous.

Purpose of the Study:

• To investigate the anatomy and pathology of the anterior epitympanum.
• To examine the role of the tensor fold in epitympanal aeration.

Main Methods:

• Dissection of 51 temporal bones (42 normal, 9 infected).
• Histological analysis of 7 serially sectioned temporal bones (5 normal, 2 infected).
• Photographic documentation of anatomical details.

Main Results:

• The tensor fold forms the anterior epitympanum wall; its angle influences supratubal recess size.
• Membrane defects in the tensor fold were observed in 27% of specimens.
• An intact tensor fold prevents inflammatory obliteration of the anterior epitympanum when the tympanic isthmus is blocked.

Conclusions:

• The anterior epitympanum is usually sealed by an intact tensor fold, though defects are common.
• Aeration occurs through the tympanic isthmus.
• Surgical management of epitympanal pathology necessitates tensor fold resection for sustained attic aeration.