Epitympanic recess

The epitympanic recess (Attic; Epitympanum) is the superior portion of the middle ear cavity (tympanic cavity) that extends above the level of the tympanic membrane. It is bounded superiorly by the tegmen tympani (a thin plate of bone forming part of the floor of the middle cranial fossa), laterally by the scutum (the bony lateral wall), and medially by the wall of the inner ear.

This space contains the head of the malleus and the body and short process of the incus, along with their supporting ligaments. The epitympanic recess communicates posteriorly with the mastoid antrum via the aditus ad antrum, providing a pathway between the middle ear and the mastoid air cells.

To summarize: Epitympanic recess + mesotympanum + hypotympanum = Tympanic cavity. Details regarding hypotympanum and other parts of tympanic cavity can be found here: Tympanic cavity.

The epitympanic recess is of particular importance in otology because:

• Cholesteatoma frequently develops in or extends into this space, often in association with a pars flaccida retraction pocket.

• Its relatively narrow communication with the mesotympanum (through the isthmus tympani) can impair ventilation and mucociliary clearance, predisposing to chronic inflammatory disease.

• Surgical access to this region (e.g., atticotomy) is a key component of tympanomastoid surgery for chronic otitis media.