No abstract

Microsurgical anatomy is a field of clinical anatomy that studies the structure and topography of small anatomical sites of organs and areas of the body under normal and pathological conditions, as applied in microsurgery. A distinctive feature of microsurgical anatomy is the study of anatomical structures in the range of magnification of stereoscopic microscope, surgical loupes and surgical microscope. When studying microsurgical anatomy otolaryngologist learns about macromicroscopic structure and morphometric characteristics of the upper respiratory tract, extraorgan macromicroscopic topography, intraorgan histotopography, macromicroscopic characteristic of blood vessels and nerve trunks. The methods of microscopic preparation and histotopography occupy a leading position in the study of microsurgical anatomy of ENT-organs. These methods make it possible to obtain information about fine macromicroscopic topographical relationships of the studied subjects without impairment of small blood vessels, nerves and other anatomical structures, and enable otorhinolaryngologists improve their microsurgical skills, and make preparation in the same sequence as surgical access and surgical approach. The study of microsurgical anatomy of ENT is the necessary basis for improvement surgical otorhinolaryngology, since most of the present-day ENT interventions are carried out using a magnifying instrument (ear surgery, microlaryngoscopy, endonasal functional surgery etc.). The knowledge of such morphometric parameters as thickness, diameter, angles of arrangement, mutual microtopography, shape geometry, the distance between the small anatomical structures, biomechanical characteristics, currently represent an essential component of substantiation of microsurgical operation techniques in otorhinolaryngology, enabling the operating otolaryngologist to carry out surgical interventions with the maximum possible safety, efficiency and functionality.

The objective of the present work was to overview the currently available literature data on microtopographic anatomy of the anterior portion of the middle ear and the external auditory passage. Manipulations on these structures during miringoplasty surgery appear to be the most difficult and laborious operations because this space is anatomically very narrow and curved; moreover, it contains the important intimate structures of the middle ear and is located very close to the temporomandibular joint. The knowledge of microsurgical anatomy of the anterior part of the middle ear and the external auditory passage is paramount in the context of the improvement of the professional skills of the surgeons. The current literature data provide a basis for the conclusion that many aspects of microsurgical anatomy of the anterior part of the tympanic cavity and the external auditory passage thus far remain poorly explored. This assertion is especially true as regards the relief of the mucous membrane overlying these structure and their supply with arterial blood. Further clarification of these aspects is needed.