{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T18:28:08Z","timestamp":1772648888635,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,4,23]],"date-time":"2016-04-23T00:00:00Z","timestamp":1461369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH NIDCD","award":["U24 DC011968"],"award-info":[{"award-number":["U24 DC011968"]}]},{"name":"International Hearing Foundation"},{"DOI":"10.13039\/100001873","name":"Starkey Hearing Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001873","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Lions 5m International and Scientific and Technological Research Council of Turkey (TUBITAK) Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To compare the volume of the epitympanic space, as well as the area of the tympanic isthmus, in human temporal bones with retraction pockets to those with chronic otitis media without retraction pockets and to those with neither condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Comparative human temporal bone study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We generated a three\u2010dimensional model of the bony epitympanum and measured the epitympanic space. We also compared the area of the tympanic isthmus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean total volume of the epitympanum was 40.55 \u00b1 7.14 mm<jats:sup>3<\/jats:sup> in the retraction pocket group, 50.03 \u00b1 8.49 mm<jats:sup>3<\/jats:sup> in the chronic otitis media group, and 48.03 \u00b1 9.16 mm<jats:sup>3<\/jats:sup> in the neither condition group. The mean volume of the anterior, lateral, and medial compartments in temporal bones in the retraction pocket group was significantly smaller than in the two control groups (<jats:italic>P<\/jats:italic> &lt; 0.05). Total epitympanic volume was also significantly smaller in the retraction pocket group than in both control groups (<jats:italic>P<\/jats:italic> &lt; 0.05). The mean area of the tympanic isthmus was significantly smaller in the retraction pocket group (8.11 \u00b1 2.44 mm<jats:sup>2<\/jats:sup>) than in the chronic otitis media group (9.82 \u00b1 2.06 mm<jats:sup>2<\/jats:sup>) or the neither condition group (10.66 \u00b1 1.78 mm<jats:sup>2<\/jats:sup>) (<jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data indicate that temporal bones with retraction pockets have a smaller volume bony epitympanum and a smaller tympanic isthmus area as compared with temporal bones from both control groups. The smaller volume tympanic isthmus in the retraction pocket group may suggest that a blockage in the aeration pathways to the epitympanum could create dysventilation, resulting in negative pressure and ultimately in retraction pockets and cholesteatomas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 126:E369\u2013E374, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25937","type":"journal-article","created":{"date-parts":[[2016,4,23]],"date-time":"2016-04-23T14:55:10Z","timestamp":1461423310000},"source":"Crossref","is-referenced-by-count":16,"title":["Epitympanum volume and tympanic isthmus area in temporal bones with retraction pockets"],"prefix":"10.1002","volume":"126","author":[{"given":"Rafael da Costa","family":"Monsanto","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Banco de Olhos de Sorocaba Hospital Sorocaba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique Furlan","family":"Pauna","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Campinas Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serdar","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Gebze Fatih State Hospital Gebze Kocaeli Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6mer","family":"H\u0131zl\u0131","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."},{"name":"Giresun A. Ilhan Ozdemir State Hospital Giresun Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geeyoun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael M.","family":"Paparella","sequence":"additional","affiliation":[{"name":"Paparella Ear Head and Neck Institute Minneapolis Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebahattin","family":"Cureoglu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,23]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"534","article-title":"Le diaphragme inter\u2010attico\u2010tympanique du nouveaune","volume":"13","author":"Chatellier HP","year":"1946","journal-title":"Ann Otolaryngol Chir Cervico\u2010Fac (Paris)"},{"key":"e_1_2_6_3_1","first-page":"505","article-title":"Epitympanic compartment surgical considerations: reevaluation","volume":"16","author":"Palva T","year":"1995","journal-title":"Am J Otol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01804289"},{"key":"e_1_2_6_5_1","first-page":"700","article-title":"Incudal folds and epitympanic aeration","volume":"17","author":"Palva T","year":"1996","journal-title":"Am J Otol"},{"key":"e_1_2_6_6_1","first-page":"307","article-title":"Tensor fold and anterior epitympanum","volume":"18","author":"Palva T","year":"1997","journal-title":"Am J Otol"},{"key":"e_1_2_6_7_1","first-page":"485","article-title":"Attic aeration in temporal bones from children with recurring otitis media: tympanostomy tubes did not cure disease in Prussak's space","volume":"21","author":"Palva T","year":"2000","journal-title":"Am J Otol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2014.08.006"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000623"},{"key":"e_1_2_6_10_1","first-page":"145","article-title":"Chronic inflammatory ear disease and cholesteatoma: creation of auxiliary attic aeration pathways by microdissection","volume":"20","author":"Palva T","year":"1999","journal-title":"Am J Otol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0385-8146(85)80013-4"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221510006254X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894760850S214"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20841"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1985.00800040050004"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24165"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199805000-00011"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1983.tb01670.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318214ea62"},{"key":"e_1_2_6_20_1","first-page":"265","article-title":"Tympanic membrane retraction pockets. 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