PubMed · 6855412
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G K Sharma. 1983. Atelectatic middle ear.. https://doi.org/10.1288/00005537-198306000-00027
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Development of modern diagnostic procedure requires inframacroscopic description of tympanic cavity. This description has to suit the special requirements of diagnostic endoscopy, too. The authors made an attempt to describe clinical anatomy of the tympanic cavity. For endoscopic investigation transtympanic, transtubal and transmastoidal approaches were used, out of which the transmastoidal has the least clinical importance. Using the transtympanic approach, detailed anatomical description of the medial wall, the auditory ossicles and the stapedius muscle can be given. Using the transtubal approach, the epitympanic region, stapedius and tensor tympani muscle and two major nerves, chorda tympani and tympanic nerve can be also investigated. Using transmastoidal approach, auditory ossicles were seen, but it was possible to identify lateral part of epitympanic recess, as well.
In most cases, the cause of facial paralysis can be determined on the basis of the clinical evaluation, and expensive diagnostic tests can be avoided. Because Bell's palsy is not always the cause, physicians need to be able to identify critical findings on history and physical examination that indicate an alternative diagnosis. Once identified, these findings can lead to a specific and directed evaluation.
A classification of tympanic retraction pockets is indispensable in order to standardise their evaluation. In this manner, the evolution of the pathology can be carefully followed and the most appropriate therapy chosen. The authors propose adapting their classification to endoscopy which permits the inspection of the depths of certain pockets, otherwise invisible to examination under microscope, thus ensuring a better follow-up.