Location of the Tympanic Nerve Relative to the Round and Oval Windows

Background: The aim of the study was to measure the distance of the tympanic nerve to the oval window and round window niche in adult cadavers for evaluating its usability as an anatomical landmark during middle ear-related surgeries, including stapedotomy and cochleostomy, and for preventing its iatrogenic damage during surgical practices such as otosclerosis surgery and cochlear implantation. Methods: The middle ears of 10 adult cadavers aged 74.70 ± 14.56 years were bilaterally dissected with the help of an endoscope and microscope to measure the distance of tympanic nerve to round window niche and oval window. Results: Tympanic nerve was found as 1.60 ± 0.86 mm (range, 0-3.11 mm) and 1.55 ± 0.38 mm (range, 1.04-2.20 mm) away from round window niche and oval window, respectively. In relation to the quantitative values of these 2 distances, neither right–left nor male–female significant differences were determined (P > .05). Tympanic nerve was observed in all temporal bones. In terms of the shape and twigs of tympanic nerve, extreme variations among cadaveric temporal bones were determined. Tympanic nerve-round window niche distance between 0-1 mm was defined as type 1 (20%), between 1 and 2 mm as type 2 (45%), between 2 and 3 mm as type 3 (30%), and between 3 and 4 mm as type 4 (5%). Conclusion: Tympanic nerve may be vulnerable at round window niche- or oval window-related surgeries (e.g., cochleostomy).