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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4399_Библиотеки_им_академика_М_И_Перельмана
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Labeled corresponding MR image—vertical section nine.
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Temporal Bone Histology and Radiology Atlas168
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VERTICAL SECTION 10
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Temporal Bone Histology and Radiology Atlas170
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VERTICAL SECTION 11
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Temporal Bone Histology and Radiology Atlas172
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ACKNOWLEDGMENTS
The authors thank Ayala Rosenbaum, MD of Rosetta
Radiology, New York, for providing the radiographic
images.
REFERENCES
1. Yadav SPS, Ranga A, Sirohiwal BL, Chanda R. Surgical
anatomy of tympano-mastoid segment of facial nerve. In-
dian J Otolaryngol Head Neck Surg 2006;58;1:27–30.
2. Mancini F, Taibah AK, Falcioni M. Complications and their
management in tympanomastoid surgery. Otolaryngol Clin
North Am.
3. Moreano EH, Paprella MM, Zelterman D, Goycoolea MV.
Prevalence of facial canal dehiscence and of persistent stapedial artery in the human middle ear: a report of 1000
temporal bones. Laryngoscope, 1994;104:309–320.
4. Jethanemest D, Angeli SI. Complications of temporal bone
infection. In: Sataloff’s Comprehensive Textbook of Otolaryn-
gology: Head & Neck Surgery. JP Medical Publishers, New
Delhi, India, 2015.
5. Shakeel M, Spielmann PM, Jones SE, Hussain SS. Direct
measurement of the round window niche dimensions using
a 3-dimensional moulding technique—a human cadaveric temporal bone study. Clin Otolaryngol. 2015 Dec;40(6):
657–661.
1999 Jun;32(3):567–583
CHAPTER 9
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Complete Temporal Bone Study
Sebahattin Cureoglu, Sujana S. Chandrasekhar, and Michael M. Paparella
The following temporal bone histological sections are
from the right ear of an adult woman. The temporal
bone was removed with the bone plug saw. The sections have proceeded from the superior to inferior in a
horizontal plane. The reader is encouraged to use these
images as a self-test of their anatomical knowledge. The
reader may refer back to the labeled images in Chap ter 6 for clarification.
FIGURE 9–1
In this section, the horizontal semicircular canal, the
body of the incus, head of the malleus, and malleoincudal joint are seen. The facial nerve is seen in both
the tympanic region and the internal auditory meatus.
The corresponding CT scan image shows the malleus,
incus, vestibule, lateral semicircular canal, internal auditory canal, cochlea, tensor tympani muscle, and carotid artery, as well as other structures including the
mastoid air cells.
lar canal are seen, as are the epitympanic ossicles. There
is a large air cell in the petrous apex.
FIGURE 9–3
In this section, we see two pneumatized cells, which are
anterior to the ossicles, in the epitympanum. They are
separated from the middle ear by connective tissue and
bony trabeculae. The anterior epitympanic recess is located anterior to the head of the malleus. It is common
for cholesteatoma to extend into this recess. The surgeon must be alert to search for cholesteatoma in this
sinus when doing surgery. On the medial wall of the
middle ear, the facial nerve is seen within its bony canal.
The vestibular nerve is seen from the semicircular canal
crista into the internal auditory canal. The cochlea is
seen anterior to the IAC. The corresponding CT scan
shows the anterior epitympanic recess in front of the
malleus head, the scutum laterally, the facial nerve and
horizontal canal on the medial wall of the middle ear,
and, anteriorly, the cochlea. The bony canal of the vestibular nerve and the IAC are seen.
In this histological section, we see the vertical crest of
the internal auditory canal (Bill’s bar) separating the
facial nerve and superior vestibular nerves. The basal
turn of the cochlea and the vestibule are clearly seen.
In the corresponding CT image, Bill’s bar is seen, the
facial nerve extends from its labyrinthine segment to
the geniculate ganglion, the larger ampullated end and
smaller nonampullated end of the superior semicircu-
FIGURE 9–2
FIGURE 9–4
The lateral semicircular canal bulges prominently into
the mastoid antrum. It bows in the horizontal plane. The
lateral canal occupies the same plane as its mate of the
other ear. The superior vestibular nerve and facial nerve
are seen in the IAC. Higher magnification can show vestibular ganglion cells (Scarpa’s ganglion cells) located
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Figure 9–1a
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Figure 9–1b
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