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Understanding Epitympanum in Detail

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Epitympanum is an integral part of the middle ear. It plays a very crucial role in sound transmissions. Continue reading this article to know more.

Medically reviewed by

Dr. Oliyath Ali

Published At July 31, 2023
Reviewed AtJanuary 22, 2024


The epitympanum is a critical area to consider in diagnosing and treating various ear conditions. It can be involved in certain middle ear infections, cholesteatoma (non-cancerous growth of skin cells in the middle ear), and other conditions affecting hearing and balance. Surgical procedures, such as tympanoplasty or mastoidectomy, may involve assessing and addressing issues within the epitympanum to restore or improve hearing function. Learn more about epitympanum in this article.

What Is Epitympanum?

The epitympanum, a part found within the middle ear, is a compact and small air-filled space. It is positioned above the eardrum and beneath the tegmen tympani, a thin bony plate positioned to achieve a separation from the brain; the epitympanum serves as a crucial component of the broader middle ear cavity. This interconnected region shares association with other ear spaces, including the mastoid air cells and the Eustachian tube. The epitympanum's inner lining comprises a delicate mucous membrane while hosting crucial structures responsible for hearing and maintaining balance. Within the epitympanum, several anatomical structures can be identified:

  • Chorda Tympani: This branch of the facial nerve traverses through the epitympanum and carries taste fibers to the anterior two-thirds of the tongue.

  • Incus: Also known as the anvil, the incus is one of the three small bones found in the middle ear. It resides within the epitympanum and acts as a linkage between the malleus (hammer) and the stapes (stirrup). Its crucial function is to transmit sound vibrations from the eardrum to the inner ear.

  • Aditus Ad Antrum: This opening connects the epitympanum with the mastoid air cells, which are part of the mastoid process situated behind the ear. This connection permits the equalization of air pressure and facilitates the drainage of fluids from the middle ear.

Why Is Epitympanum Important?

Epitympanum is an important structure due to its following functions:

  1. Sound Transmission: The epitympanum serves as a pathway for sound waves to reach the middle ear. When the sound waves pass the ear canal, they strike the tympanic membrane, causing vibrations. These vibrations are then transmitted through the epitympanum to the ossicles, which amplify and transmit the sound to the inner ear for further processing.

  2. Ventilation and Pressure Regulation: One crucial role of the epitympanum is to facilitate ventilation and regulate pressure within the middle ear. It is connected to the mastoid air cells, which are air-filled spaces in the temporal bone behind the ear. This connection allows for the equalization of pressure between the middle ear and the external environment. Proper pressure regulation is vital for the optimal functioning of the middle ear and helps prevent discomfort, pain, and potential damage to the eardrum.

  3. Eustachian Tube Function: The epitympanum communicates with the Eustachian tube, a narrow tube connecting the middle ear to the back of the throat. The Eustachian tube plays a crucial role in equalizing pressure in the middle ear and facilitating fluid drainage, which helps maintain a healthy middle ear environment. The proper functioning of the Eustachian tube is essential in preventing conditions like middle ear infections or otitis media.

  4. Disease Evaluation and Treatment: The epitympanum is also important for the evaluation and treatment of various ear diseases, including cholesteatoma (abnormal skin growth in the middle ear) or middle ear tumors. It serves as a significant area for assessing these conditions and performing surgical interventions. In certain cases, surgical procedures may involve accessing and clearing the epitympanum to remove pathological tissue or reconstruct damaged structures.

What Are the Problems Associated if Epitympanum Does Not Function Properly?

If the epitympanum does not function properly, several problems may arise, including:

  1. Eustachian Tube Dysfunction: The Eustachian tube connects the middle ear to the back of the throat, allowing for equalization of pressure on both sides of the eardrum. If the epitympanum is not functioning properly, it can disrupt the normal functioning of the Eustachian tube. This can lead to Eustachian tube dysfunction, causing symptoms such as ear pain, pressure or fullness in the ear, muffled hearing, and recurrent ear infections.

  2. Middle Ear Infections: When the epitympanum is not functioning properly, it can impair the drainage of fluid from the middle ear. This stagnant fluid creates a conducive environment for the growth of bacteria or viruses, leading to middle ear infections, also known as otitis media. Symptoms may include ear pain, hearing loss, ear drainage, and fever.

  3. Cholesteatoma: A cholesteatoma is an abnormal growth of skin cells that can occur in the middle ear or mastoid region when the epitympanum is not functioning properly. It typically develops as a result of chronic middle ear infections or Eustachian tube dysfunction. A cholesteatoma can cause progressive hearing loss, ear discharge, and dizziness, and if left untreated, it can lead to complications such as bone erosion and damage to the facial nerve.

  4. Conductive Hearing Loss: Dysfunction of the epitympanum can interfere with the normal transmission of sound through the middle ear. This can result in conductive hearing loss, where sound is not efficiently conducted to the inner ear. It may cause reduced hearing sensitivity, difficulty understanding speech, and a sensation of the ears being blocked.

  5. Tympanic Membrane Abnormalities: The epitympanum and its proper function are closely associated with the health of the tympanic membrane. If the epitympanum is dysfunctional, it can contribute to tympanic membrane abnormalities such as retraction pockets or tympanosclerosis (thickening and scarring of the eardrum).

How Can a Person Care For Epitympanum?

In order to ensure proper care for the epitympanum and maintain good ear health, there are several key steps to follow.

  • Firstly, practice gentle ear hygiene by cleaning the outer ear with a washcloth during bathing without inserting objects into the ear canal.

  • It is important to seek prompt medical treatment for any ear infections to prevent complications and protect the functioning of the epitympanum.

  • During activities that involve changes in altitude, such as air travel, use techniques like swallowing, yawning, or gently blowing with one’s mouth closed and nose pinched to equalize ear pressure.

  • Protecting the ears from loud noises is also crucial, as prolonged exposure can damage the epitympanum and other ear structures.

  • Manage allergies and nasal congestion effectively to reduce the risk of Eustachian tube dysfunction.

  • Adopting a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking or secondhand smoke, can promote overall ear health.

  • Schedule regular check-ups with an ear care specialist to monitor ear health, identify any potential issues with the epitympanum or middle ear, and receive appropriate guidance or treatment tailored to one’s specific needs.


The epitympanum is a critical component of maintaining optimal ear function. When the epitympanum does not function properly, it can lead to various complications such as Eustachian tube dysfunction, middle ear infections, cholesteatoma, conductive hearing loss, and abnormalities of the tympanic membrane. In order to promote the health of the epitympanum and overall ear well-being, it is important to practice gentle ear hygiene, promptly address any ear infections, manage allergies and nasal congestion effectively, protect the ears from loud noises, employ proper ear equalization techniques during pressure changes, and maintain a healthy lifestyle. Regular check-ups with an ear care specialist are also recommended to monitor the condition of the epitympanum and address any potential issues in a timely manner. By following these measures, individuals can take proactive steps to support the proper functioning of the epitympanum and reduce the likelihood of complications or difficulties associated with the middle ear.

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Dr. Oliyath Ali
Dr. Oliyath Ali

Otolaryngology (E.N.T)


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