Investigating the tympanic membrane blood supply: A preliminary cadaver study

Investigating the tympanic membrane blood supply: A preliminary cadaver study

Objectives: This study aims to investigate the arterial and venous vascularization of the tympanic membrane (TM) with coloredvessel embalming procedure in fresh cadaver heads, as a guide for minimally invasive tympanoplasty procedures.Patients and Methods: This study was performed on two fresh frozen cadaver heads (4 ears, 1 male, 1 female). After vesselembalming procedure the TM was examined with rigid endoscopes and the mini vascular plexuses of the TM and external auditorycanal were observed.Results: There is increased vascularization of the posterior superior part of the TM, and the main blood supply derives from themallear region. The posterior half of the tympanic membrane has richer perfusion compared to the anterior half.Conclusion: Awareness of the vascular pattern of the TM allows modification of manipulations during tympanoplasty; the poorlyvascularized anterior part of the TM must be protected for successful graft healing.

___

  • 1. Wullstein H. Theory and practice of tympanoplasty. Laryngoscope 1956;66:1076-93.
  • 2. Dornhoffer JL. Hearing results with cartilage tympanoplasty. Laryngoscope 1997;107:1094-9.
  • 3. Rizer FM. Overlay versus underlay tympanoplasty. Part I: historical review of the literature. Laryngoscope 1997;107:1-25.
  • 4. Tarabichi M. Endoscopic transcanal middle ear surgery. Indian J Otolaryngol Head Neck Surg 2010;62:6-24.
  • 5. Bilge O, Celik S. Cadaver embalming fluid for surgical training courses: modified Larssen solution. Surg Radiol Anat 2017;39:1263-72.
  • 6. Applebaum EL, Deutsch EC. An endoscopic method of tympanic membrane fluo- rescein angiography. Ann Otol Rhinol Laryngol 1986;95:439-43.
  • 7. Hellstrom S, Spratley J, Eriksson PO, Pais-Clemente M. Tympanic. Membrane Vessel Revisited: A Study in an Animal Model, Otology & Neurotology 2003;24:494-99.