Comprehensive and Clinical Anatomy of the Middle Ear by Salah Mansour Jacques Magnan Hassan Haidar Karen Nicolas & Stéphane Louryan

Author:Salah Mansour, Jacques Magnan, Hassan Haidar, Karen Nicolas & Stéphane Louryan
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

The tympanic diaphragm is not fully horizontal because its components are on different levels. It separates the upper unit of the attic superiorly from the mesotympanum and the lower unit of the attic, the Prussak’s space, inferiorly. The lateral malleal fold separates Prussak’s space from the upper unit of the epitympanum; this is why we call the Prussak’s space the lower unit of the attic [61] (see Sect. 4.5).

3.6.4 The Tympanic Isthmus

The mesotympanum connects with the Eustachian tube. However, the attic and the mastoid are isolated from the mesotympanum by the tympanic diaphragm. Attic aeration occurs through a 2.5-mm opening in the tympanic diaphragm called the tympanic isthmus (Fig. 3.41).

Fig. 3.41Superior view of a right middle ear showing the tympanic diaphragm and the tympanic isthmus. The tympanic isthmus could be divided into anterior and posterior isthmus by the medial incudal fold (MIF). The green arrows represent the normal route of attic aeration from the mesotympanum. AMLF anterior malleal ligamental fold, TTF tensor tympani fold, LMF lateral malleal fold, LIMF lateral incudomalleal fold, AML anterior malleal ligament, LML lateral malleal ligament, PIL posterior incudal ligament, TTM tensor tympani muscle tendon, CP cochleariform process, PE pyramidal eminence, LSCC lateral semicircular canal, PB petrous bone

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