Article Type

Original Study


Objectives: (1) Describe the relations of the facial recess (FR) to the sinustympani (ST), posterior tympanic sinus (PTS), lateral tympanic sinus (LTS),mastoid segment of the facial nerve (FN), and stapedius muscle (STM)based on their otoendoscopic, surgical, and radiologic anatomy and in relationto their development theories. (2) Evaluate the possible surgical approaches. Methods:Fifty-five temporal bones were dissected, and the anatomic detailswere studied utilizing an operating microscope and otoendoscopes ofdifferentangles. In addition, the recesses anatomy and relations were studiedin 200 temporal bones computed tomography scans.Results:Theretrotympanic recesses pneumatization could be classified asaxial(FR) and sagittal (ST, PTS, and LTS). The 3 sagittal recesses showedfixedrelations to each other, with ST and PTS medially (superiorly and inferiorly,respectively) and LTS laterally. FR inlet located superolateral to theothersinuses while the recess itself extended laterally (44%) and posteriorly(20%) to them and in relation to the FN and SM. When ST was extensivelypneumatized, it showed a direct relation with the FR extension posteriortothe FN. Although it was possible to approach all 4 recesses endoscopicallyvia the transcanal route, it was necessary to approach FR and ST viacombinedtranscanal and transmastoid approaches when they were extensivelypneumatized posteriorly and laterally.Conclusions:Relationsbetween the FR and the retrotympanic structuresaresignificantly variable and influenced mainly by the type and extent of thepneumatization.Extensively or unusually pneumatized types need specialor combined approaches

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.