title: Pyramidal eminence and subpyramidal space: an endoscopic anatomical study.
abstract: OBJECTIVE
  To describe retrotympanic endoscopic anatomy, especially the pyramidal eminence and contiguous spaces.
  
  
  METHODS
  This was an anatomical study on a prospective case series.
  
  
  METHODS
  The anatomy of the retrotympanum was studied by endoscopy in nine patients affected by cholesteatoma who underwent tympanomastoid surgery and in six temporal bone dissections.
  
  
  RESULTS
  Pneumatization of the sinus tympani and posterior tympanic sinus or both, noted in 12 ears out of 15, may give rise to a recess beneath the pyramidal eminence, which we have called the subpyramidal space. This space can manifest with a variable degree of depth, shape, or extent depending on the shape and dimensions of the pyramidal eminence.
  
  
  CONCLUSIONS
  Endoscopic exploration of the middle ear may guarantee a very good exposure of retrotympanic structures, allowing detailed anatomical descriptions of hidden areas. Improvement in our knowledge of the anatomy may decrease the possibility of residual disease during cholesteatoma surgery.
authors.affiliation: Otolaryngology Department, University Hospital of Modena, Modena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marchioni
authors.forename: Matteo
authors.initials: M
authors.lastname: Alicandri-Ciufelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Grammatica
authors.forename: Francesco
authors.initials: F
authors.lastname: Mattioli
authors.forename: Livio
authors.initials: L
authors.lastname: Presutti
mesh_terms: D002102:Cadaver; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004432:Ear, Middle / Q000033:anatomy & histology*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D011446:Prospective Studies; D013701:Temporal Bone / Q000033:anatomy & histology