During intact canal wall mastoidectomy for cholesteatoma, the surgeon performs a posterior tympanotomy (facial recess approach) to access the middle ear. The boundaries of the facial recess are formed by the facial nerve medially, the chorda tympani laterally, and the pyramid inferiorly. Which structure is opened through this approach to access the facial recess?

• A The space between the incus long process and the stapes
• B The space between the facial nerve and the chorda tympani ✓
• C The sinus tympani posterior to the oval window
• D The supratubal recess anterior to the malleus

Explanation

The posterior tympanotomy (facial recess approach) is made by opening the space between the facial nerve medially and the chorda tympani nerve laterally, providing access to the posterior mesotympanum, oval window, and round window niche. The chorda tympani is the lateral landmark that protects the surgeon from lateral dissection beyond the middle ear. This is a standard surgical technique in intact canal wall procedures for cholesteatoma.

Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.