Exploring the Epitympanum: Anatomy, Pathology, and Examination Questions

OtoPrep Epitympanum
Epitympanum Anatomy in Otolaryngology Examinations

Epitympanum Anatomy in Otolaryngology Examinations

Introduction to the Epitympanum

The epitympanum, also known as the attic or epitympanic recess, is the most superior portion of the tympanic cavity. It is a compact and small air-filled space, positioned above the eardrum and beneath the tegmen tympani, playing a crucial role in sound transmission and in various ear conditions.

How well do you know the Epitympanum?

Identify these structures on the image above:
1. Chorda tympani
2. Cog
3.Facial nerve
4. Tensor tympani
5. Processus Cochleariformis
6. Stapedial tendon
7. Lenticular process
8. Posterior crus 9. Stapes footplate
10. Anterior crus
11. Manubrium
12. Umbo

Anatomical Structures in the Epitympanum

  • Chorda Tympani: Nerve carrying taste sensations from the anterior two-thirds of the tongue and supplying parasympathetic fibers to the submandibular and sublingual glands.
  • Cog: Bony ridge separating compartments in the epitympanum.
  • Facial Nerve: Travels through the facial canal in the temporal bone, just medial to the epitympanum.
  • Tensor Tympani: Muscle dampening the vibrations of the tympanic membrane.
  • Processus Cochleariformis: Bony eminence serving as the fulcrum for the tensor tympani muscle.
  • Stapedial Tendon: Connects the stapedius muscle to the stapes bone.
  • Lenticular Process: Small projection from the incus articulating with the stapes.
  • Posterior Crus: One of the two limbs of the stapes bone.
  • Stapes Footplate: Fits into the oval window between the middle ear and the inner ear.
  • Anterior Crus: Other limb of the stapes bone.
  • Manubrium: Handle-like part of the malleus attached to the tympanic membrane.
  • Umbo: Most depressed point of the tympanic membrane, at the end of the manubrium of the malleus.

Pathologies in the Epitympanum

Conditions like cholesteatoma and chronic otitis media can affect the epitympanum, leading to disorders such as tympanic membrane abnormalities and middle ear tumors.

Potential Examination Questions

  1. Anatomy: "Identify the structures found in the epitympanum separated by the Cog."
  2. Pathology: "Discuss the implications of cholesteatoma in the epitympanum."
  3. Diagnostic Procedures: "What are the diagnostic imaging modalities for assessing the epitympanum?"
  4. Treatment: "What surgical approaches are used for treating pathologies in the epitympanum?"
  5. Clinical Scenarios: "A patient presents with hearing loss and discharge; suspecting an epitympanic involvement, what are your diagnostic steps?"