Palva T, Johnsson L G
Department of Otolaryngology, University of Helsinki, Finland.
Am J Otol. 1995 Jul;16(4):505-13.
The epitympanic compartments and the anatomy of the atticotympanic diaphragm were examined in a pair of serially sectioned temporal bones with secretory otitis media and chronic otitis media, respectively. Findings confirmed reports of 19th century scientists in that Prussak's space has a wide connection to the mesotympanum through the posterior pouch of Tröltsch and may have an additional narrow passage in its roof to the lateral malleal space. The lateral incudomalleal fold regularly separates the upper lateral attic from the lower lateral attic and the mesotympanum. The medial incudal fold as a rule is atrophic already at birth. The anterior tympanic isthmus thus extends from the tensor tympani tendon to the posterior incudal ligament and is the main passage for epitympanic and mastoid aeration. Opening(s) in the tensor fold, when present, are also important. In some ears, the posterior tympanic isthmus may form an auxiliary narrow route for aeration via the incudal fossa. The isthmi may be blocked by middle ear infection, which can lead to chronic mastoid and attic disease. Pathways for cholesteatoma spread in the epitympanum are discussed.
分别在一对患有分泌性中耳炎和慢性中耳炎的连续切片颞骨中，检查了上鼓室隔和鼓室鼓膈的解剖结构。研究结果证实了19世纪科学家的报告，即普鲁萨克间隙通过特罗尔茨后隐窝与中鼓室有广泛的连通，并且在其顶部可能有一条通向外侧锤骨间隙的额外狭窄通道。外侧砧锤韧带通常将上鼓室的上外侧部分与下外侧部分及中鼓室分隔开。内侧砧骨韧带通常在出生时就已经萎缩。因此，鼓室前峡从鼓膜张肌肌腱延伸至砧骨后韧带，是上鼓室和乳突气腔的主要通气通道。如果存在，鼓膜张肌皱襞中的开口也很重要。在一些耳朵中，鼓室后峡可能形成一条通过砧骨窝的辅助狭窄通气途径。峡部可能被中耳感染阻塞，这可能导致慢性乳突和上鼓室疾病。文中还讨论了胆脂瘤在上鼓室扩散的途径。
