Middle ear microvascularization: an "in vivo" endoscopic anatomical study.

Alicandri-Ciufelli, Matteo; Guarino, Pierre; Fabbri, Filippo; Cunsolo, Elio Maria; Presutti, Livio; Anschütz, Lukas Peter (2018). Middle ear microvascularization: an "in vivo" endoscopic anatomical study. European archives of oto-rhino-laryngology, 275(4), pp. 889-894. Springer 10.1007/s00405-018-4905-8

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PURPOSE To describe the in vivo vascularization of middle ear by an endoscopic point of view, particularly focusing on the medial wall of tympanic cavity and incudostapedial region (ISR). STUDY DESIGN Case series with surgical videos review and anatomical description. METHODS 48 videos from exclusive endoscopic middle ear surgery performed at the University Hospital of Modena from November 2015 to July 2017 were reviewed. Data about anatomy of vessels, and blood flow direction (BFD) were collected in an appropriate database for further analyses. RESULTS 48 cases were included in the present study. In 18/48 patients (37,5%), a clearly identifiable inferior tympanic artery (ITA) was present, running just anteriorly to the round window (RW), with a superior BFD (65% of cases) from the hypotympanic region toward the epitympanum. Some promontorial variants were described in 67% of cases and the most common finding was a mucosal vascular network with a multidirectional BFD. On the ISR, an incudostapedial artery (ISA) was detected in 65% of cases with BFD going from the long process of the incus (LPI) toward the pyramidal eminence in the majority of cases. CONCLUSION The vascular anatomy and BFD of the medial wall of the tympanic cavity can be easily studied in transcanal endoscopy. ITA (with a superior BFD in most cases) and ISA (with a main BFD from the incus to the stapes) are the most constant identifiable vessels.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Anschütz, Lukas Peter


600 Technology > 610 Medicine & health








Stefan Weder

Date Deposited:

23 Jan 2019 12:52

Last Modified:

28 Oct 2019 15:06

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Blood flow Endoscopic ear surgery Incudostapedial artery Incudostapedial joint Inferior tympanic artery Middle ear anatomy Middle ear vascularization Promontory





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