The malleus cap: Anatomic description of cartilage of the lateral process of the malleus

Publication date: Available online 25 October 2017
Source:American Journal of Otolaryngology
Author(s): Elias Michaelides, Ankit Kansal, Sara Rutter, Christopher A. Schutt
PurposeTo anatomically describe a cartilaginous cap attached to the lateral process of the malleus.Study Design.Histologic and gross anatomic review.MethodsTwenty temporal bones were histologically reviewed. The anatomical relationship between the tympanic membrane and malleus was then defined at the level of the lateral process of the malleus and the long process of the malleus. Separately, gross evaluation of these levels at the macroscopic level was undertaken through endoscopic imaging in five subjects.ResultsAll temporal bones reviewed revealed the presence of a cartilaginous cap articulating between the tympanic membrane and the lateral process of the malleus. The cartilaginous cap was also readily identifiable in gross evaluation of the tympanic membrane from views lateral and medial to the tympanic membrane during endoscopic evaluation.ConclusionThe cartilaginous cap of the lateral process of the malleus is an important and reliable anatomical structure of the middle ear that has not previously been described. Through knowledge of the structure surgeons may exploit its presence by creating a cleavage plane between the cartilaginous cap and the malleus during tympanoplasty, possibly allowing for safer and more efficient surgery.



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