Cheiţă A C, Măru Nicoleta, Mogoantă Carmen Aurelia, Ioniţă Elena
Department of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Rom J Morphol Embryol. 2010;51(1):61-8.
To study the anatomy of the posterior tympanic wall and to describe the four recesses (Sinus Tympani-ST, Lateral Tympanic Sinus-LTS, Posterior Tympanic Sinus-PTS, Facial Recess-FR) with their variations in shape, dimension, internal configuration.
Thirty-seven cadaver temporal bones were examined through the anterior dissection approach. The opening was enlarged by drilling to allow a good microscopic or rigid endoscopic view to the retro-tympanum. Measurements of the recesses were made with gradually millimeter wire, dial micrometric indicator (comparator clock), various right angled picks and sometimes by means of cast-impression--used in stomatology for dental impression (interior configuration).
Out of 37 specimens, we have found PTS in 64.86% (24 cases), ST in 94.59% (35 cases), and LTS in 59.45% (22 cases). For FR, we have found four types. The most constant cell, located in the inferior external part of FR and in the same time, the biggest one was suprapyramidal Sappey's fossa, which we have found in 75.67% (28 cases) of all specimens. Sinus entrance of each recess was very variable, but in the most cases, we have found that the long diameter of ST and LTS was usually directed vertically and of PTS usually horizontally. The deeper recess was ST-2.74 mm (range 0.5 to 6.2 mm). Pyramidal eminence was visualized in 100% of cases, the pyramidal ridge in 89.18%, the chordal ridge in 78.37%, the suprapyramidal ridge in 35.13%, ponticulus in 83.78% and subiculum in 75.67%. In many cases, the inner configuration of each sinus was irregular, presenting either small recesses (0.2 to 1 mm) under the bone borders at the entrance in the sinuses or communication between the two sinuses.
Presence of the all four recess is not a rule. Marked variation in the size and shape and especially in the internal configuration of all recesses is a rule. All recesses of the retro-tympanum can be recognized more easily, if we identify at first all elements of positive projection (pyramidal eminence, chordal ridge, styloid eminence, styloid ridge, pyramidal ridge, suprapyramidal ridge, ponticulus, subiculum).
研究鼓室后壁的解剖结构，并描述四个隐窝（鼓窦隐窝 - ST、鼓室外侧隐窝 - LTS、鼓室后隐窝 - PTS、面神经隐窝 - FR）的形状、尺寸及内部结构的变异情况。
采用前路解剖法对37具尸体颞骨进行检查。通过钻孔扩大开口，以便能清晰地用显微镜或硬性内镜观察鼓室后部。使用逐渐变细的毫米线、表盘式测微指示器（比较时钟）、各种直角探针，有时还借助在口腔医学中用于取牙印的铸型印模（内部结构）来测量隐窝。
在37个标本中，发现PTS的有64.86%（24例），ST的有94.59%（35例），LTS的有59.45%（22例）。对于FR，发现有四种类型。最常见的细胞，位于FR的下外部，同时也是最大的细胞，是锥上萨佩氏窝，在所有标本中有75.67%（28例）可发现。每个隐窝的窦口差异很大，但在大多数情况下，发现ST和LTS的长径通常垂直，PTS的长径通常水平。最深的隐窝是ST - 2.74毫米（范围为0.5至6.2毫米）。100%的病例能看到锥隆起，89.18%能看到锥嵴，78.37%能看到弦嵴，35.13%能看到锥上嵴，83.78%能看到小阜，75.67%能看到下丘。在许多情况下，每个窦的内部结构不规则，在窦口的骨边缘下方有小隐窝（0.2至1毫米），或者两个窦之间相通。
并非所有四个隐窝都一定存在。所有隐窝在大小、形状，尤其是内部结构上存在显著变异是常见现象。如果我们首先识别出所有正投影的元素（锥隆起、弦嵴、茎突隆起、茎突嵴、锥嵴、锥上嵴、小阜、下丘），鼓室后部的所有隐窝会更容易识别。
