Licensures and activities:
■ Licensed as ENT Consultant in Kuwait, Egypt and
Khairy Alhag Abu Shara, M.D.
Senior consultant ENT, Head and Neck
Surgeon, Sabah and MTC Hospitals, Kuwait
Education:
■ M.D. Ear, Nose and Throat Surgery.
May 1992, Faculty of medicine,
Cairo University Kasr Al-Ainy Medical School
■ M.S. Ear, Nose and Throat Surgery.
May 1985 (very good degree), faculty of medicine,
Cairo University Kasr Al-Ainy Medical School
■ M B & Bch Nov. 1981 (very good degree), faculty of
medicine, Cairo University Kasr Al-Ainy Medical
School
Posts:
■ Senior Consultant at ENT department, Sabah and MTC
hospitals, Ministry of Health (MOH), Kuwait
■ Lecturer of otorhinolaryngology, department of
surgery, faculty of medicine, Kuwait university 1996,
ongoing. (Mandated from MOH).
■ X-Chairman of ENT medical council in Kuwait.
December 1999 – April 2006.
■ X-Chairman of ENT department, Al-Sabah Hospital,
Kuwait, July 1999 – April 2006.
■ Resident at Cairo University Medical School, ENT
department, Kasr Al-Ainy Hospital, Egypt,
from 2nd March 1983 until 28 Feb. 1986.
■ House officer at Cairo university hospitals, Egypt,
from 1st march 1982 – 28 Feb. 1983.
Sudan.
■ Referee of the Kuwait Medical Journal.
■ Member of the Faculty of Surgery, Kuwait Institute for
Medical Specialization (KIMS) since October 1998,
ongoing.
■ X-chairman of the inspection board for private hospitals,
MOH, Kuwait.
■ X-Member of the operational policy follow-up team
MOH, Kuwait.
■ X-Member of the accreditation standards setup com-
mittee for hospitals and primary health care centers,
MOH, Kuwait.
■ Visiting professor, Khartoum university, faculty of
medicine.
■ Director of the first temporal bone course, Kuwait,
November 2005.
Publications:
19 publications in national, regional and international
journals, 12 presentations, 8 posters and booklets.
Awards and certificates of honor:
1. From KMA on the occasion of obtaining the M.D.
degree.
2. From the Egyptian medical syndicate on the occasion
of obtaining the M.D. degree.
3. The first prize of the 11th course in otology and oto-
neurosurgery, 5–7 Dec. 2000, hôpital Purpan,
Toulouse, France.
4. From the 3rd International Conference of the Gulf
Cooperation Council (GCC) Otorhinological, Head &
Neck Societies & Associations. March 98.
5. From the Sudanese ENT association.
6. From the minister of health of Kuwait for editing the
operational policy of the ENT departments in Kuwait,
May 2000.
7. From the minister of health, Kuwait, for the 3rd edition
of the operational policy of the ENT departments in
Kuwait, Febr. 2002.
8. Support for research from the “Kuwait Foundation for
Advancement of Science” (KFAS).
9. From the faculty of surgery, Kuwait Institute for Medical
Specialization (KIMS)
10. From the director of Sabah medical area.
DISSECTION MANUAL FOR THE
TEMPORAL BONE LABORATORY
KHAIRY ALHAG ABU SHARA, M.D.
Senior Consultant ENT, Head and Neck Surgeon
Sabah and MTC Hospitals, Kuwait
X-Chairman of ENT Medical Council – MOH 99-06

To my mother,
from whom I have learned how
sincere hard work can be
an endless source of enjoyment.

To my Family,
for their unlimited support
and understanding of the medical profession
as well as its obligations and commitments.
4 Dissection Manual for the Temporal Bone Laboratory

Acknowledgement
The growth of medico-legal problems related to surgical practices
necessitates greater emphasis on clinical training. Lab practice on
cadavers and various models is becoming increasingly popular for both
research and training.
The challenges of ear surgery are unique because the density of
anatomical structures in a relatively small space is unlike any other
organ in the human body. This consequently calls for extensive lab train-
ing before starting to operate in the theater—a step that should only be
taken once both the trainer and trainee are satisfied with the level of
skills achieved.
For those reasons, the establishment of a temporal bone lab within the
otology center is an inevitable option.
Considering the short time frame given during a temporal bone dissec-
tion course – in which the participants are concerned mainly with hands-
on training rather than going into further theoretical details – this manual
nevertheless provides practical and concise orientation to the topic. The
author’s aim was not to write a textbook, but to address the actual
needs in a temporal bone lab, which is why this manual should be sup-
ported by more detailed training instructions and further readings.
I hope, this booklet will be of great help to our junior candidates and to
the seniors who are planning to establish a temporal bone lab.
A special word of gratitude goes to KARL STORZ company for their kind
support and valuable assistance in the preparation of this booklet.
Khairy Alhag Abu Shara, M.D.
Senior Consultant ENT, Head and Neck Surgeon
Sabah and MTC Hospitals, Kuwait
Email: Khairy86@yahoo.com
Phone: 00965 9784104
Dissection Manual for the Temporal Bone Laboratory 5

Foreword
Middle ear surgery involves procedures that are among the most chal-
lenging in the field of ORL, demanding a high degree of technical skill,
expertise and precision. To become a proficient otologist requires good
orientation skills and thorough knowledge of numerous anatomical
structures confined to a space amounting to less than one cubic inch.
Furthermore, the introduction of the surgical microscope, dental drill and
fine instruments requires the development of precise operative tech-
niques.
The introduction of high-resolution CT scanners, 1 mm cuts and MRI
enables surgeons to gain a more detailed knowledge of fine anatomical
structures, e.g., the thickness of the stapes foot plate in stapes surgery,
the facial nerve anatomy, and the possibility of any associated congenit-
al anomalies in cochlear implantation.
Full anatomical orientation regarding both normal and abnormal variants
is the first step to be taught in temporal bone labs. Otherwise avoidable
complications could occur.
It has been suggested by many authors that prior to performing in-vivo
surgery in an operating theater, a trainee surgeon should acquire good
knowledge of temporal bone anatomy and develop proper navigational
skills to such a degree comparable to the uncanny sense of direction
that allows us to find our way through our own bedroom in complete
darkness. It takes a long time to become an ear surgeon and even more
time to gain the required level of proficiency to successfully manage dif-
ficult and complicated cases. The temporal bone dissection lab pro-
vides an entry point, where candidates can devote their efforts to work-
ing toward this goal.
In this manual, information is given about the anatomy of the temporal
bone, the various surgical procedures, that can be practiced on cadaver
specimen in the lab (including photos, adressing procedures, and con-
cepts), imaging procedures, and a suggested temporal bone laboratory
setup.
6 Dissection Manual for the Temporal Bone Laboratory

Anatomical schematic drawings: Dissection Manual for the Temporal Bone Laboratory
Mr. Andreas Mücke Khairy Alhag Abu Shara, M.D.
Karl-Frank-Str. 32 Senior Consultant ENT, Head and Neck Surgeon
12587 Berlin, Germany Sabah and MTC Hospitals, Kuwait
X-Chairman of ENT Medical Council – MOH 99-06

Most of the photographs shown in Address for correspondence:

this manual were taken by the author Khairy Alhag Abu Shara, M.D.
during dissection sessions in the Senior Consultant ENT, Head and Neck Surgeon
temporal bone laboratory. Sabah and MTC Hospitals, Kuwait
Email: Khairy86@yahoo.com
Phone: 00965 9784104

© 2007 Endo-PressTM, Tuttlingen, Germany

ISBN 978-3-89756-151-9, Printed in Germany
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and clinical experience broaden our knowledge, changes in
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Dissection Manual for the Temporal Bone Laboratory 7

Table of Contents

Acknowledgement ................................................................................................................... 4

Forword...................................................................................................................................... 5

1.0 Introduction ........................................................................................................................ 8

2.0 Training Procedures............................................................................................................ 13

3.0 Endoscopic Views of the Temporal Bone ......................................................................... 24

4.0 Temporal Bone CT Images

4.1 Axial CT Scans ............................................................................................................. 28
4.2 Coronal CT Scans ....................................................................................................... 35

5.0 Exposure of the Temporal Bone: Genuine Dissections................................................... 39

Remember ......................................................................................................................... 42
8 Dissection Manual for the Temporal Bone Laboratory

1.0 Introduction

Squamous portion

Petrous portion

Mandibular fossa
Tympanic portion
Zygomatic process

Mastoid portion

Styloid portion

Fig. 1
Left temporal bone, lateral view with the squama sculptured as
an auricle. There are two temporal bones. Each is composed of
five parts: mastoid, petrous, squamous, tympanic plate and
styloid process.

Internal auditory meatus

Basisphenoid
Nerves of the jugular foramen

Basiocciput
Sigmoid sinus
Jugular tubercle

Vessels of the jugular foramen

Hypoglossal canal

Occipitomastoid suture
Occipital condyle
Squamous part of the
occipital bone

Fig. 2
Right temporal bone attached to the occipital bone. View of the
posterior cranial fossa. The internal auditory meatus (IAM),
jugular foramen and notch, sigmoid sinus, superior and inferior
petrosal sinuses, petrous apex, clivus, and hypoglossal canal
can be seen.
Dissection Manual for the Temporal Bone Laboratory 9

Foramen rotundum

Superior orbital fissure Foramen spinosum

Foramen ovale
Anterior clinoid process
Superior petrosal sulcus

Internal carotid artery

Foramen lacerum

Occipital condyle

Sella turcica Clivus

Fig. 3
Right temporal bone attached to sphenoid and occipital bones.
View of the middle cranial fossa. The foramina (rotundum, ovale,
spinosum, and lacerum), the superior orbital fissure, internal
carotid artery, anterior clinoid process, clivus, petrous apex,
cavum trigeminale, greater wing of the sphenoid, petro-
sphenoid and petro-occipital suture lines are visible.

Zygomatic root Mandibular fossa

Tympanic plate
Squamo-sphenoid suture
Mastoid tip
Stylo-mastoid foramen
Foramen spinosum
Digastric fossa
Foramen ovale
Styloid process
Carotid canal

Jugular tubercle
Occipital condyle

Jugular bulb

Fig. 4
External view of the skull base. The jugular foramen, carotid
canal, greater wing of the sphenoid, the foramina (ovale,
spinosum, lacerum), zygomatic root, mandibular fossa, styloid
process, squamo-sphenoid suture, occipital condyle, digastric
fossa, stylo-mastoid foramen, and mastoid tip are visible.
10 Dissection Manual for the Temporal Bone Laboratory

Superior SCC

Cochlea

Common crus
Oval window

Posterior SCC Lateral SCC

Fig. 5
Right inner ear. The three semicircular canals (SCC) are open,
the lateral, the posterior and the superior with crus commune
are visible. The cochlea and oval window are also exposed.

Superior SCC

Lateral SCC

Oval window
Facial nerve
Modulus
Remnant of promontory

Cochlea: basal turn

Round window

Fig. 6
Left inner ear. The superior and lateral SCC, facial nerve,
oval and round windows, cochlea, modulus, and promontory.
Dissection Manual for the Temporal Bone Laboratory 11

Malleus handle and

tympanomeatal flap Long incus process

Lenticular incus process

Stapes head
Incudo-stapedial joint

Promontory Stapedial tendon

Fig. 7
Anatomy of the left middle ear: The incudo-stapedial joint, the
stapes head and the crura, facial nerve, stapedial tendon,
promontory, and tympanomeatal flap are visible.

2 Incus
Short process
2 Body
1 Malleus
1 Lenticular process
Head
Neck Long process
Lateral process
Handle

3 Stapes
Posterior crus

Head

Neck

Anterior crus
3
Footplate
Fig. 8
The auditory ossicles.
1 The malleus, head, neck, lateral process, and handle.
2 The incus: body, short, long, and lenticular processes.
3 The stapes: head, neck, anterior and posterior crura,
and footplate.
12 Dissection Manual for the Temporal Bone Laboratory

Cochleariform process

Semi-canal of the
Facial nerve tensor tympani muscle
(transverse segment)
Middle ear Transverse part
of the carotid canal

Vertical part
of the carotid canal
Jugular bulb
Carotico-jugular foramen

Fig. 9
Right side dissection. Notice the jugular bulb, carotid canal,
both vertical and horizontal parts, carotico-jugular septum,
and foramen for the IX cranial nerve, cochlea, oval window,
facial nerve, cochleariform process, semi-canal of the tensor
tympani muscle, and lateral SCC.
Dissection Manual for the Temporal Bone Laboratory 13

2.0 Training Procedures

General rules
• Specimen should be taken out of the
refridgerator one hour before dissection.
• All needed instruments should be available.
• Temporal bone should be in surgical
position.
• Rapid review of the gross anatomy.
• Verify operational integrity of the drill and
perform an initial function test .
• Leave your bones in a labeled plastic bag.
Sanitary rules
• Anti-hepatitis vaccination.
• Wear gowns, gloves, overshoes, safety
glasses and face mask to prevent bone dust
inhalation and entry of a bone splinter into the
eye.
• Avoid injuries by using proper instruments.
• Remaining bones and dust should be
handled as medical wastes.
• Leave the working area clean and tidy for
the next group.

The bones should be removed from the surgical position, as if in the operating theater.
refridgerator at least one hour before dissection. The zygomatic root is anterior, and the mastoid
First, determine whether the bone is right or left, tip is inferior (Fig. 10a)
and secure it with a temporal bone holder in a

Zygomatic root

External auditory meatus

Mastoid tip
Squama

Digastric notch

Fig. 10a
Left temporal bone with soft tissues.

Identify important landmarks related to different anatomic views of the temporal bone, for example:
• Zygomatic root • Petrous part of temporal bone and its apex
• Mastoid tip • Cavum trigeminale
• Digastric notch • Arcuate eminence
• External auditory meatus • Internal auditory meatus
• Squamous part of temporal bone • Cranial nerves VII, VIII, IX and X
(spaghetti-like structure)
14 Dissection Manual for the Temporal Bone Laboratory

1. Attempt soft tissue procedures, such as:

• Periosteal incision and dissection
• Dissection of the posterior meatal skin
down to the annulus.

Sometimes the candidate cannot practice the

soft tissue work properly if formalinized speci-
mens or macerated bones are used.
The candidate should be familiar with the anatomy
of macerated bones (Figs. 10d and 10e).

Vertical and
transverse incisions
Transmeatal transverse and
T- shaped incision vertical skin incisions
Craniotomy flap
U- shaped incision

Obliteration flap

Fig. 10b
Different periosteal incisions and flaps.

The Golden Rules of Drilling:

• Hold the drill securely with a steady hand
• Never perform blind drilling!
• Proper burr type, size and shape.
• Parallel direction
• Excavate, but never penetrate.
• Use suction-irrigation and prevent overheating.

2. Drill a code number on the squama to prac-

tice control of the drill handpiece, which
should be held and used like a pencil. Never
apply undue force to avoid losing control
and causing subsequent, potentially cata-
strophic injury.
Dissection Manual for the Temporal Bone Laboratory 15

Posterior meatal wall

Antrum External auditory meatus

Dural plate
Cells of the mastoid tip
Lateral SCC
Digastric ridge
Posterior tympanotomy

Sinus plate Drill

Fig. 10c
The art of drilling.

Squama

Zygomatic root

Mastoid
External auditory meatus

Tympanic plate
Carotid canal
Digastric notch

Petrous bone

Fig. 10d
Anatomy of macerated bones. Lateral surface.

Squama

Mastoid
Arcuate eminence
Petrous bone

Internal auditory meatus

Fig. 10e
Anatomy of macerated bones: Medial surface.
16 Dissection Manual for the Temporal Bone Laboratory

Fig. 10f
Left myringotomy and grommet insertion.

Malleus handle and

tympanomeatal flap Long incus process

Lenticular incus process

Stapes head
Incudo-stapedial joint

Promontory
Stapedial tendon

Fig. 11
Left anterior tympanotomy.
Dissection Manual for the Temporal Bone Laboratory 17

Tympanomeatal flap

Annulus fibrosus Malleus handle

Chorda tympani

Long process of incus

Promontory

Incudostapedial joint Posterior meatal wall

Posterior crus of stapes

Fig. 12a
Left anterior tympanotomy (schematic drawing).

Teflon piston

Long process of incus

Lenticular process of incus

Pyramidal process

Promontory
Shaft

Fig. 12b
Left stapedectomy and teflon piston insertion.

3. Practice myringotomy and grommet

insertion (Fig. 10f).

4. Practice anterior tympanotomy: a tympano- Check the annulus, incudo-stapedial joint, stapes
meatal flap is created by removal of the suprastructures, stapedial tendon, pyramidal
posterior meatal wall and exploration of the process, facial nerve, chorda tympani, malleus
middle ear (Figs. 11, 12a). Practice stape- handle, tympanic membrane, promontory, and
dectomy and teflon piston insertion (Fig.12b) round window.
In-vitro fixation can be achieved by injecting
adhesive glue around the footplate or into
the labyrinth through a “decapitated” superior
SCC at the arcuate eminence.
18 Dissection Manual for the Temporal Bone Laboratory

Zygomatic root

Antrum
External auditory meatus
Squama
Posterior meatal wall
Lateral SCC Tip cells

Dural plate Sinus plate

Sinodural angle

Fig. 13
Right cortical mastoidectomy.

External auditory meatus

Lateral semicircular canal Posterior meatal wall

Facial nerve
Dural plate

Digastric ridge
Antrum

Sinus plate

Sinodural angle

Fig. 14
Right cortical mastoidectomy (schematic drawing).

5. Perform myringoplasty, in which a piece of
periosteum is harvested and used as a graft
which is positioned with the underlay tech-
nique to repair a previously created tympanic
membrane perforation.
6. Practice a cortical mastoidectomy (Figs.
13, 14). Identify the spine of Henle, then
start with the largest cutting burr in the
MacEwen’s triangle between the inferior
temporal line, tangent to the posterior meatal
wall and the spine of Henle. This triangle
serves as a landmark for localizing the mastoid
antrum. Drilling should be accompanied by con-
tinuous irrigation and performed parallel to the
anticipated border without leaving behind any
overhangs. Never work blindly. The antrum, which
is the largest mastoid air cell, has the lateral SCC
on its floor. Cells over the dural and sinus plates
are drilled, the sinodural angle is identified, and
cells behind the sinus are cleared. Identify the
digastric ridge and clear the peri-facial and deep
mastoid air cells. Keep the posterior bony
meatal wall intact.
Dissection Manual for the Temporal Bone Laboratory 19

Incus body

Posterior meatal wal

Antrum

Incudo-stapedial joint

Short process of incus

Window of the posterior
tympanotomy Lateral SCC

Facial nerve

Fig. 15
Left posterior tympanotomy.

Posterior meatal wall

Body of incus process

Incudo-stapedial joint
Promontory
Chorda tympani Round window

Facial nerve Dural plate

Lateral semicircular canal
Sinus plate

Fig. 16
Left posterior tympanotomy (schematic drawing).

7. Perform posterior tympanotomy (Figs. 15, 16)
by initially gaining access to the middle ear
from the mastoid cavity while ensuring that
the tympanic membrane and annulus
remain intact. A cortical mastoidectomy is
performed to deepen the sinodural angle
and thin the posterior meatal wall. The incus
body and its short process are identified.
Drilling begins with the 2 mm-diamond burr
between the incus short process, chorda
tympani, and facial nerve down to the middle
ear. The incudostapedial joint, promontory and
round window niche should be visible.
Note: You can fill the external auditory meatus
with a colored fluid. This fluid should not leak
into the mastoid. If leakage occurs, it is an
early alarm that the annulus, tympanic mem-
brane or posterior meatal wall was injured.
20 Dissection Manual for the Temporal Bone Laboratory

Lateral SCC (de-roofed)

Perifacial cells
Antrum

Posterior SCC (de-roofed)

Endolymphatic sac
opened with a sickle knife

Sigmoid sinus

Fig. 17
Right saccus decompression.

External auditory meatus

Digastric ridge
Posterior meatal wall
Axis of lateral
semicircular canal
Axis of posterior
semicircular canal
Dural plate
Endolymphatic sac

Sinus plate

Sinodural angle

Fig. 18
Right saccus decompression (schematic drawing).

8. Identify the endolymphatic sac (Figs. 17, 18).
Both lateral and posterior SCCs are exposed
but not opened. The peri-sinus cells are
drilled, and an imaginary line is passed along
the lateral SCC, perpendicular to the poste-
rior SCC. The bone inferior to this line is then
thinned out and removed with a needle. The
lateral wall of the sac is identified and incised
using a sickle knife.
Dissection Manual for the Temporal Bone Laboratory 21

Cortical
mastoid

Nose of the
implant
dummy in
the recess
created for
electrodes

Dummy
inserted
into the
implant site

Fig. 19
Cochlear implant bed.

Posterior
meatal wall
Second
cochleostomy

Window of
the posterior
tympanotomy

Cochleostomy

Fig. 20 Fig. 21
Right double cochleostomy. Electrode hugging the modulus of the right
cochlea (counter-clockwise).

9. A cochleostomy is performed (Fig. 20) after Note: This step needs to be performed under
preparation of the cochlear implant bed
(Fig. 19) and cortical mastoidectomy with supervision of a trainer.
posterior tympanotomy. An attempt can be
made under visual control with the cochlea
opened from posterior so the electrode is
constantly under direct vision during inser-
tion (Fig. 21).
22 Dissection Manual for the Temporal Bone Laboratory

Zygomatic root

Stapes Middle ear

Dural plate Lateral SCC

Tip cells
Sinodural angle
Sinus plate

Fig. 22
Right radical mastoidectomy.

Tendon of the tensor

tympani muscle
Dural plate
Semi-canal of the Promontory
tensor tympani muscle

Cochleariform process Facial nerve

Lateral semicircular canal Round window

Stapes

Dural plate

Sinus plate

Fig. 23
Right radical mastoidectomy (schematic drawing).

10. Perform a radical mastoidectomy (Figs. 22,
23) by drilling through the posterior meatal
bony wall down to a level just above a line
from the lateral SCC to the digastric ridge,
removing the bridge over the attic area, as
well as the anterior and posterior buttresses. The
anterior attic is also cleared. Identify the facial
nerve, semicanal of the tensor tympani muscle
and the cochleariform process tendon. Try to com-
plete an ossiculoplasty procedure.
Dissection Manual for the Temporal Bone Laboratory 23

Facial nerve

Superior SCC

Lateral SCC

Posterior SCC

Fig. 24
Left labyrinthectomy.

Stapes

Facial nerve
Superior semicircular canal
Lateral semicircular canal
Posterior semicircular canal
Dural plate

Sinus plate

Fig. 25
Left labyrinthectomy (schematical drawing).

11. Perform a labyrinthectomy (Fig. 24, 25) by mond burr to the vestibule. Preserve the anterior
first identifying the domes of the three SCC. part of the lateral SCC to avoid injury to the facial
Open the canals and follow with a small dia- nerve.
24 Dissection Manual for the Temporal Bone Laboratory

3.0 Endoscopic Views of the Temporal Bone

Pars flaccida

Lateral malleus process

Malleus handle

Pars tensa

Umbo Cone of light

Fig. 26
Right tympanic membrane.

Semicanal of the
tensor tympani muscle
Tendon of the tensor
tympani muscle Long incus process
Malleus handle
Middle ear

Tympanic membrane
Incudo-stapedial joint
Umbo

Eustachian tube

Fig. 27
Oto-endoscopic view of the right middle ear through the
Eustachian tube.
Dissection Manual for the Temporal Bone Laboratory 25

Attic
Semicanal of the
tensor tympani muscle
Facial nerve

Eustachian tube Oval window

Mesotympanum Pyramid
Ponticulus promontorii
Subiculum promontorii
Promontory
Sinus tympani

Hypotympanic cells Round window

Fig. 28
Left middle ear.

Fallopian canal

Bill’s bar
Superior vestibular area

Transverse crest

Inferior vestibular area

Cochlear area
Singular nerve

Fig. 29
Right internal auditory meatus.
26 Dissection Manual for the Temporal Bone Laboratory

Fallopian canal
Superior vestibular area

Bill’s bar
Transverse crest

Cochlear area
Inferior vestibular area

Singular nerve

Fig. 30
Left internal auditory meatus.

Right internal auditory meatus

(de-roofed)

Spiral lamina
Modiolus

Cochlea (opened)

a b
Fig. 31a, b
a Right internal auditory meatus (de-roofed) and cochlea
opened with modiolous and spiral lamina visible.
b MRI insert image provides orientation about the position of
the cochlea in (a).
Dissection Manual for the Temporal Bone Laboratory 27

Internal auditory meatus

Facial nerve

Cochlear nerve Vestibular nerve

Dural sleeve

Fig. 32
Endoscopic view of the right internal auditory meatus (IAM).
The vestibular, cochlear and facial nerves are contained within
the sheath of the dura mater.
28 Dissection Manual for the Temporal Bone Laboratory

4.0 Temporal Bone CT Images

The following CT images very effectively illustrate
the osteological details needed for this course

4.1 Axial CT Scans

Axial CT sections that include 1 mm cuts with
overlap are appropriate for temporal bone visu-
alization. The cuts start from the level of the
mastoid tip and continue up to the level of the
superior SCC.
Some authors link the anatomical structures
with mnemonic cartoon symbols that aid in
memorizing the major structures and their char-
acteristics, such as:

Mnemonic Anatomical Mnemonic Anatomical

symbols structure symbols structure

Internal
Jugular bulb
auditory
and inferior
meatus
petrosal sinus
(IAM)
Duck bill Funnel

Cochlear Incus and

aqueduct malleus
Horn Ice cream cone

Basal turn of Attic, aditus,

the cochlea and antrum
Smile Hour glass

Cochlea Carotid artery

Horns Inverted L

Vestibular
Common crus
aqueduct
Slit
Spot

Lateral SCC Superior SCC

Bucket handle Snake eyes

Dissection Manual for the Temporal Bone Laboratory 29

Try to refresh your knowledge

with the axial sections listed below.

Sphenoid sinus
Foramen spinosum
Anterior cranial fossa
Great wing of the sphenoid
Squamo-sphenoid suture

Foramen ovale
Carotid artery (transverse)
Mandibular condyle
Sphenoid body
Carotid artery (vertical)
External auditory meatus
Inferior petrosal sinus

Jugular vein
Sinus plate

Mastoid cortex Posterior cranial fossa

Occipito-mastoid suture

Fig. 33

Sphenoid sinus

Anterior cranial fossa

Great wing of the sphenoid

Foramen ovale
Foramen spinosum
Mandibular condyle Carotid artery (transverse)
Petrous apex
External auditory meatus
Facial nerve Sphenoid body

Jugular vein
Mastoid cortex
Posterior cranial fossa
Sigmoid sinus

Fig. 34
30 Dissection Manual for the Temporal Bone Laboratory

Sphenoid sinus

Foramen spinosum
Great wing of the sphenoid

Mandibular condyle Foramen ovale

Sphenoid body
Middle ear
Carotid artery (transverse)
External auditory meatus
Eustachian tube

Facial nerve Cochlea

Posterior cranial fossa

Sigmoid sinus

Fig. 35

Middle ear Great wing of the sphenoid

Foramen ovale
Mandibular condyle
Carotid artery (transverse)
Tympanic membrane Sphenoid body
and malleus
Petrous apex
External auditory meatus

Cochlea
Facial nerve

Sigmoid sinus Posterior cranial fossa

Fig. 36
Notice the basal turn of the cochlea, middle ear and the
cochlear aqueduct.
Dissection Manual for the Temporal Bone Laboratory 31

Foramen rotundum

Middle ear Carotid artery (transverse)

Tympanic membrane Round window

and malleus
Cochlea
Facial nerve
Cochlear aqueduct
Sinus tympani
Ampullary end of the
Posterior semi-circular canal posterior semi-circular canal
Posterior cranial fossa

Fig. 37
Notice the cochlea, posterior SCC, sinus tympani, semi-canal
of the tensor tympani muscle, round window, facial nerve,
chorda tympani, tympanic membrane, and malleus handle.

Foramen rotundum

Semicanal of the tensor

tympani muscle

Carotid artery (transverse)

Middle ear and
auditory ossicles
Cochlea
Facial nerve

Sinus tympani
Posterior cranial fossa
Common crus

Fig. 38
32 Dissection Manual for the Temporal Bone Laboratory

Middle ear and ossicles

Carotid artery
Anterior and posterior
crura of the stapes Semicanal of the tensor
tympani muscle
Malleus
Long incus process Petrous apex

Facial nerve Cochlea

Sinus tympani Vestibule

Posterior cranial fossa

Fig. 39
Notice the long incus process.

Facial nerve Petrous apex

Incudomallear complex Cochlea

Internal auditory meatus
Lateral semicircular canal
Vestibule
Common crus
Posterior cranial fossa
Vestibular aqueduct

Fig. 40
Notice the stapes, vestibule, common crus, and facial nerve.
Dissection Manual for the Temporal Bone Laboratory 33

Mid-cranial fossa
Greater superficial
Malleus head petrosal nerve
Petrous apex
Incus body
Geniculate ganglion
Superior semicircular canal Internal auditory meatus

Posterior semicircular canal

Posterior cranial fossa

Fig. 41
Notice the “ice cream cone” (incus and malleus) ossicular
complex, vestibule, lateral SCC, facial nerve, IAM, and attic.

Mid-cranial fossa

Greater superficial
petrosal nerve
Superior semicircular canal
Petrous apex
Attic
Aditus ad antrum Internal auditory meatus
Antrum
Posterior semicircular canal Posterior cranial fossa

Fig. 42
Notice the posterior and superior semicircular canals.
34 Dissection Manual for the Temporal Bone Laboratory

Superior SCC

Fig. 43
Notice the superior SCC extending to the dome, which is
equivalent to the arcuate eminence at the mid-cranial fossa.
Dissection Manual for the Temporal Bone Laboratory 35

4.2 Coronal CT Scans

A series of 1 mm cuts with overlap are appropri-
ate for temporal bone coronal CT imaging. The
cuts start from anterior to posterior from the
level of the cochlea back to the level of the pos-
terior SCC.
Some authors link the anatomical structures
with mnemonic cartoon symbols that aid in
memorizing the major structures and their char-
acteristics, such as:

Mnemonic Anatomical Mnemonic Anatomical

symbols structure symbols structure

Superior SCC,
lateral SCC,
Scutum
basal turn of
cochlean
Three fingers Pyramid

Transverse
Malleus
crest IAM
Hammer

Labyrinth and
Vestibule and tympanic facial
round window nerve seg-
ments
Inverted tear drop Snail eyes

Eustachian
Cochlea
tube
Snail shell Inverted triangle
36 Dissection Manual for the Temporal Bone Laboratory

Try to refresh your knowledge

with the coronal sections listed below.

Tegmen tympani Attic

Facial nerve, tympanic portion Facial nerve, labyrinth portion

Middle ear Cochlea

Digastric notch
Annulus Petrous apex
Petro-occipital joint
Mandibular condyle
Carotid artery
Eustachian tube

Fig. 44
Notice the cochlea, carotid artery, Eustachian tube, middle ear,
attic, digastric notch, tympanomastoid suture, and mandibular
condyle.

Tendon of the tensor

tympani muscle
Malleus Attic
Tegmen
Cochleariform process
Mastoid air cells
Scutum Cochlea
External ear Petrous apex
Tympanic membrane Petro-occipital fissure
Annulus Middle ear
Mandibular condyle Eustachian tube

Fig. 45
Notice the attic, malleus head and neck, tendon of tensor tym-
pani muscle, tympanic membrane, middle and external ear,
Eustachian tube, petro-occipital suture, cochlea, mandibular
condyle, petrous apex, annulus, scutum, tegmen and cochleari-
form process.

Malleus Attic

Tegmen Transverse crest

Mastoid air cells
Internal auditory meatus
Scutum
Middle ear
External ear
Petrous apex
Tympanic membrane Petro-occipital

Annulus
Mandibular condyle

Fig. 46
Notice the internal auditory meatus and transverse crest, attic,
malleus, scutum, tegmen, mastoid air cells, external auditory
meatus, tympanic membrane, mandibular condyle, annulus,
petro-occipital suture, petrous apex and middle ear.
Dissection Manual for the Temporal Bone Laboratory 37

Arcuate eminence
Lateral semicircular canal
Superior semicircular canal
Tegmen tympani Vestibule
Mastoid air cells Internal auditory meatus
Body of incus Stapes footplate
Scutum Petrous apex
External ear Petro-occipital fissure
Basal turn of the cochlea
Tympanic membrane
Middle ear
Incudo-stapedial joint

Fig. 47
Notice the internal auditory meatus, basal turn of the cochlea,
superior (arcuate eminence) and lateral SCC, tympanic mem-
brane, incus, stapes footplate, tegmen tympani, lateral semicir-
cular canal, mastoid air cells, body of incus, scutum, external
ear, incudo-stapedial joint, vestibule, petrous apex, petro-
occipital fissure and middle ear.

Tegmen tympani
Middle ear
Mastoid air cells

Antrum Vestibule

Petrous apex
Tympanic membrane

External ear Round window

Fig. 48
Notice the vestibule, round window, petromastoid suture,
hypoglossal canal, and jugular bulb.

Tegmen tympani Arcuate eminence

Superior semicircular canal

Mastoid air cells
Lateral semicircular canal
Antrum

Jugular vein

Facial nerve (vertical part)

Fig. 49
Notice the jugular bulb, hypoglossal canal, mastoid cells, and
SCC.
38 Dissection Manual for the Temporal Bone Laboratory

Tegmen tympani
Superior semicircular canal

Lateral semicircular canal

Mastoid air cells
Posterior semicircular canal

Jugular vein

Hypoglossal canal
Mastoid tip

Fig. 50
Notice the posterior SCC, mastoid air cells, jugular bulb,
tegmen tympani, mastoid tip, lateral and superior SSCs and
hypoglossal canal.
Dissection Manual for the Temporal Bone Laboratory 39

5.0 Exposure of the Temporal Bone: Genuine Dissections

Cochleostomy

Eustachian tube
Superior SCC

Lateral SCC Facial nerve

Solid angle

Posterior SCC
Digastric ridge

Fig. 51

Superior incudal ligament

Body of incus

Posterior meatal wall

Attic
Short process of incus
Lateral SCC
Fossa incudis

Posterior tympanotomy

Fig. 52
40 Dissection Manual for the Temporal Bone Laboratory

External auditory meatus

Tympanic plate

Attic Incudostapedial joint

Incus Annulus

Fossa incudis Umbo

Antrum Facial nerve
Superior SCC
Lateral SCC

Posterior SCC

Fig. 53

Chorda tympani
Semicanal of tensor tympani
Tympanic membrane
Cochleariform process
Tendon of the tensor
tympani muscle Facial nerve
Malleus handle Incudostapedial joint
Superior SCC
Head of malleus
Lateral SCC
Body of incus

Short process of incus

Fig. 54

Malleus
Anterior wall of external
auditory meatus
Incus
Malleus handle
Attic
Tympanic membrane
Lateral SCC
Incudostapedial joint
Pyramidal process
Promontory

Fig. 55
Dissection Manual for the Temporal Bone Laboratory 41

Körner’s septum is an internal Antrum

extension of the petrosqua-
mous suture. May mislead
into a false antrum

Fig. 56

Oval window

Tegmen tympani Promontory

Facial nerve Round window

Superior SCC Facial nerve

Lateral SCC
Jugular bulb
Posterior SCC

Sinus plate
Fig. 57
42 Dissection Manual for the Temporal Bone Laboratory

Remember
☞ When is the right time to begin with ☞ When back to the operating room,
training in the operating room? never forget
● When both the trainer and trainee are ● Morbid anatomy.
equally satisfied about the outcome. ● Congenital anomalies.
● When the trainee is able to identify ear ● Continuous polishing of your skills.
structures as if within one’s own bedroom
in the dark.
● After watching various live surgeries.

Remember, that ear surgery is not for

amateurs; it can end with unpleasant
complications like facial nerve palsy, peri-
lymph fistula and vertigo, fatal intracranial
complications or hearing loss.
Dissection Manual for the Temporal Bone Laboratory 43

Dissection Manual for the Temporal Bone Laboratory

Instruments, Units, Video Systems and Accessories
44 Dissection Manual for the Temporal Bone Laboratory

Please note: The temporal bone dissection laboratory should be located away from all clinical and surgical activities with sanitary
arrangements managed by the infection control officer of the hospital. The number of stations is subject to the number of participants.
The main station should be equipped with a video camera and monitor for demonstration purposes. The lab should be equipped with a
large double level refrigerator for storage of the temporal bone specimens.

Checklist: Instruments for the Temporal Bone Dissection Laboratory

Each participant and main station:
❑ 123207 HOLMGREEN Endaural Ear Speculum, self-retaining, outer diameter 7 mm
❑ 223803 Seeker, with ball end, angled 45°, size 3, length 15.5 cm
❑ 224001 HOUSE Curette, large, spoon sizes 2.8 x 3.2 mm and 2.6 x 3.5 mm, length 15 cm
❑ 225205 Pick, 90º, length 16 cm, 0.5 mm
❑ 152301 Ear Hook, without ball end, size 1, length 15.5 cm
❑ 212803 LEMPERT Elevator, width 3 mm, length 19 cm
❑ 213008 PLESTER Elevator, width 8 mm, length 18 cm
❑ 208000 Surgical Handle, Fig. 3, length 12.5 cm, for blades 208010 – 19, 208210 – 19
❑ 208015 Blades, Fig. 15, non-sterile, package of 100
❑ 203710 Suction Tube, cylindrical, LUER, outer diameter 1 mm, working length 9 cm
❑ 203730 Suction Tube, cylindrical, LUER, outer diameter 3 mm, working length 11 cm
❑ 206500 FISCH Suction and Irrigation Tube, cylindrical, outer diameter of suction tube 3 mm,
irrigation tube 2 mm, working length 9.5 cm
❑ 161000 HARTMANN Ear Forceps, alligator type, serrated, working length 8 cm
❑ 223500 ROSEN Elevator, tip angled 15°, 12 mm long, width 1.5 mm, length 16 cm
❑ 280120 Temporal Bone Holder, bowl-shaped, with 3 fixation screws for tensioning the
petrosal bone and with evacuation tube for irrigation liquid

Checklist: Powered Instrumentation – UNIDRIVE® ENT

Each participant and main station:
❑ 40 7116 01-1 UNIDRIVE® ENT
consisting of:
20 7116 20-1 UNIDRIVE® ENT with KARL STORZ-SCB®,
power supply 100 – 120, 230 – 240 VAC, 50/60 Hz
400 A Mains Cord
20 0126 30 Two-Pedal Footswitch, two stage, with proportional function
20 7116 40 Silicone Tubing Set, for irrigation, sterilizable
20 7116 21 Clip Set, for use with Tubing Set 20 7116 40
20 0901 70 SCB Connecting Cable, length 100 cm
031131-01* Single Use Tubing Set, sterile, package of 3
❑ 20 7110 32 High Performance EC Micro Motor
❑ 20 7110 72 Connecting Cable, to connect EC micro motor 20 7110 32 to control unit
❑ 252475 INTRA Drill Handpiece, angled, length 12.5 cm, for use with straight shaft burrs,
transmission 1:1 (40,000 rpm)
❑ 260000 Standard Straight Shaft Burr, stainless, sizes 006 – 070, length 7 cm, set of 15
❑ 262000 Diamond Straight Shaft Burr, stainless, sizes 006 – 070, length 7 cm, set of 15

Checklist : General Equipment for Participants

Each participant:
❑ Zeiss Operating Microscope with side tube
Main station:
Main station operating microscope with:
❑ Camera control unit 20 2130 11
❑ Camera head 20 2120 34
❑ TV-Adaptor for ZEISS operating microscope 301677
❑ Optical Beamsplitter 50/50, for use with Zeiss operating microscope 301513
❑ C-Mount Microscope Adapter 20220040 and monitor 9415 N
Each participant and main station:
❑ Suction and irrigation unit
❑ Gowns
❑ Gloves
❑ Overshoes
❑ Head caps
❑ Fluid soap
❑ Tissues
❑ Disposable syringe
Dissection Manual for the Temporal Bone Laboratory 45

Instruments for the Temporal Bone Dissection Laboratory

224001 225205
223803

208015

123207 212803 213008 208000 223803 224001 225205

123207 HOLMGREEN Endaural Ear Speculum, 208015 Blades, Fig. 15, non-sterile, package of 100
self-retaining, outer diameter 7 mm 223803 Seeker, with ball end, angled 45°, size 3,
212803 LEMPERT Elevator, width 3 mm, length 15.5 cm
length 19 cm 224001 HOUSE Curette, large,
213008 PLESTER Elevator, width 8 mm, spoon sizes 2.8 x 3.2 mm and 2.6 x 3.5 mm,
length 18 cm length 15 cm
208000 Surgical Handle, Fig. 3, length 12.5 cm, 225205 Pick, 90º, length 16 cm, 0.5 mm
for Blades 208010 – 19, 208210 – 19
46 Dissection Manual for the Temporal Bone Laboratory

Instruments for the Temporal Bone Dissection Laboratory

8c
m

161000

223500
152301

161000

11 c
m
9 cm
203710 203730

152301 223500 203710 203730

9,5 cm 152301 Ear Hook, without ball end, size 1,

length 15.5 cm
223500 ROSEN Elevator, tip angled 15°,
12 mm long, width 1.5 mm, length 16 cm
206500
161000 HARTMANN Ear Forceps, alligator type,
serrated, working length 8 cm
203710 Suction Tube, cylindrical, LUER,
outer diameter 1 mm, working length 9 cm
203730 Suction Tube, cylindrical, LUER,
outer diameter 3 mm, working length 11 cm
206500 206500 FISCH Suction and Irrigation Tube,
cylindrical, outer diameter suction tube 3 mm,
geliefertiirrigation tube 2 mm,
working length 9.5 cm
280120 Temporal Bone Holder, bowl-shaped,
with 3 fixation screws for tensioning the
petrosal bone and with evacuation tube for
irrigation liquid
280120
Dissection Manual for the Temporal Bone Laboratory 47

UNIDRIVE® ENT
The high-end multifunction system for excellent
handling and convenience in the OR

One unit – six functions Special features:

• Shaver S7ystem for surgery of the paranasal
sinuses and anterior skull base • With touch screen
• Sinus Burr • Color display
• Drill • Choice between several display languages
• STAMMBERGER-SACHSE Intranasal Drill • Functions displayed in words
• Micro Saw • Clearly defined operating elements
• Dermatome • Set values of the last session are stored
• Automatic error message via text display
48 Dissection Manual for the Temporal Bone Laboratory

UNIDRIVE® ENT

Constant motor speed

• Microprocessor-controlled motor speed
• Preselected parameters are maintained during drilling
• Continuously adjustable speed of rotation
• Maximum speed of rotation can be preset
Integrated irrigation pump
• Microprocessor-controlled flow rate
• Quick and easy connection of the tubing set
• Flow rate can be controlled from the sterile area via footswitch
• Flow rate adjustable from 6–125 ml/min
2 motor outputs
• Simultaneous connection of 2 motors
• Active output can be selected from the sterile area via footswitch

Special features and benefits

Saves time
• 2 motors can be connected simultaneously
왘 no plugging or unplugging during the operation
• Automatic display of error messages
왘 no time-consuming error tracing in the operating room
• Exact reading and adjustment of motor speed
• Preselected parameters can be stored
왘 set-point values for motor speed and flow rate do not need to be readjusted with each new procedure
• Quick and easy connection of the tubing set to the pump

Relieves OR personnel
• The time for preparation prior to surgery is considerably reduced by standardization
• Irrigation flow rate and motor speed adjustable via footswitch
• Easy to use due to clearly structured design and optimized function selection
• Personnel can use the time saved for other tasks
• User can control multiple functions from the sterile area via footswitch

Saves money
• Only one unit required to perform six functions
• Most of the available shaver blades, burrs and drills are reuseable
왘 enables perfect hygienic reprocessing
• EC micro motor is compatible with various INTRA drill handpieces
Dissection Manual for the Temporal Bone Laboratory 49

UNIDRIVE® ENT

Technical specifications:

Mode Handpiece No. Motor

speed
(max.) rpm

Shaver mode
Operation mode: oscillating
Max. rev. (rpm): in conjunction with Micro Shaver Handpiece 40 7110 35 3,000*
in conjunction with Paranasal Sinus Shaver Handpiece 40 7110 39 7,000*
in conjunction with DrillCut-X Shaver Handpiece 40 7110 40 7,000*

Sinus Burr mode

Operation mode: rotating
Max. rev. (rpm): in conjunction with DrillCut-X Shaver Handpiece 40 7110 40 12,000

Drilling mode
Operation mode: counter-clockwise or clockwise
Max. rev. (rpm): in conjunction with EC Micro Motor 20 7110 32 40,000
and Connecting Cable 20 7110 72

Micro Saw mode

Max. rev. (rpm): in conjunction with EC Micro Motor 20 7110 32 20,000
and Connecting Cable 20 7110 72

Intranasal Drill mode

Max. rev. (rpm): in conjunction with EC Micro Motor 20 7110 32 60,000
and Connecting Cable 20 7110 72

Dermatome mode
Max. rev. (rpm): in conjunction with EC Micro Motor 20 7110 32 8,000
and Connecting Cable 20 7110 72

* Approx. 3000 rpm is recommended as this is the most efficient suction/performance ratio.

Power supply: 100-120, 230-240 VAC, 50/60 Hz

Dimensions: 304 x 164 x 263 mm

(w x h x d)

Two outputs for parallel connection of two motors

Integrated irrigation pump

Flow rate: 6-125 ml/min, adjustable in 8 steps

Touch Screen: 6.4" / 300 cd/m2

Weight: 6.1 kg

Certified to: IEC 60-1 CE acc. to MDD

Selectable
display English, French, German, Spanish,
languages: Italian, Portuguese, Greek, Turkish
50 Dissection Manual for the Temporal Bone Laboratory

UNIDRIVE® ENT

20 7116 20-1

40 7116 01-1 UNIDRIVE® ENT

consisting of:
20 7116 20-1 UNIDRIVE® ENT with KARL STORZ
Communication Bus System ®,

power supply: 100 – 240 VAC, 50/60 Hz

400 A Mains Cord
20 0126 30 Two-Pedal Footswitch, two-stage,
with proportional function
20 7116 40 Silicone Tubing Set, for irrigation, sterilizable
20 7116 21 Clip-Set, for use with tubing set 20 7116 40
20 0901 70 SCB Connecting Cable, length 100 cm
031131-01* Disposable tubing set, sterile

* mtp medical technical promotion gmbh,

Take-Off Gewerbepark 46, D-78579 Neuhausen ob Eck, Germany
Dissection Manual for the Temporal Bone Laboratory 51

UNIDRIVE® ENT Two-Pedal Footswitch Silicone Tubing Set

System Components

20 0126 30 20 7116 40

UNIDRIVE® ENT

U N I T S I D E

PAT I E N T S I D E

EC Motor STAMMBERGER-CASTELNUOVO STAMMBERGER, Paranasal Sinus Micro Shaver Handpiece

with Connecting Cable DrillCut-X Shaver Handpiece Shaver Handpiece straight, with integrated EC-Micro
with integrated suction / irrigation 90° angle, with connecting cable Motor and Connecting Cable
channel and longer shaver blade,
with connecting cable

20 7110 32 40 7110 39
20 7110 72 40 7110 40 20 7110 70 40 7110 35

INTRA Drill Handle Shaver Blade, straight Shaver Blade, straight

252475 - 252495 41201 KN 40201 KN

Intranasal Drill Shaver Blade, curved Shaver Blade, curved

660000 41202 KN 40302 KN

Micro Saw Sinus Burr

254000 - 254300 41305 DN

Dermatome

253000 - 253300
52 Dissection Manual for the Temporal Bone Laboratory

INTRA Drill Handpieces

252475 INTRA Drill Handpiece, angled,

length 12.5 cm,
for use with straight shaft burrs,
252475 transmission 1:1 (40,000 rpm)

Burrs
Straight Shaft Burrs, length 7 cm

7 cm

Standard Diamond
Transverse
Dia. Tungsten Diamond,
Detail Size for single Tungsten for single
mm Carbide coarse
use, sterile, sterilizable Carbide use, sterile, sterilizable
set of 5 set of 5
006 0.6 – 260006 261006 – – 262006 –

007 0.7 – 260007 – – – 262007 –

008 0.8 – 260008 261008 – – 262008 –

010 1 – 260010 261010 – – 262010 –

014 1.4 – 260014 261014 261114 – 262014 –

018 1.8 – 260018 261018 – – 262018 –

023 2.3 260023 D 260023 261023 261123 262023 D 262023 262223

027 2.7 – 260027 261027 – – 262027 262227

031 3.1 260031 D 260031 261031 261131 262031 D 262031 262231

035 3.5 – 260035 261035 – – 262035 262235

040 4 260040 D 260040 261040 261140 262040 D 262040 262240

045 4.5 – 260045 261045 – – 262045 262245

050 5 260050 D 260050 261050 261150 262050 D 262050 262250

060 6 260060 D 260060 261060 261160 262060 D 262060 262260

070 7 – 260070 261070 – – 262070 262270

260000 Standard Straight Shaft Burr, stainless, 262000 Diamond Straight Shaft Burr, stainless,
sizes 006 – 070, length 7 cm, set of 15 sizes 006 – 070, length 7 cm, set of 15
Dissection Manual for the Temporal Bone Laboratory 53

TELECAM® SL II n
Camera Heads

For use with TELECAM® SL II Camera Control Unit 20 2130 11U

TELECAM® One-Chip Camera Head

20 2120 30 PAL TELECAM®

20 2121 30 NTSC One-Chip Camera Head

color systems PAL/NTSC, with integrated Parfocal Zoom

20 2120 30 / 20 2121 30 Lens, f = 25 – 50 mm (2x), 2 freely programmable camera
head buttons

TELECAM® C-MOUNT One-Chip Camera Head

20 2120 34 PAL TELECAM® C-MOUNT

20 2121 34 NTSC One-Chip Camera Head

color systems PAL/NTSC, 2 freely programmable camera

head buttons
20 2120 34 / 20 2121 34

TELECAM® SL II
Camera Control Unit

20 2130 11U TELECAM® SL II Camera Control Unit

color systems PAL/NTSC, with integrated digital
Image Processing Module
consisting of:
20 2130 20 TELECAM® SL II Camera
Control Unit
400 A Mains Cord
20 2001 30U Keyboard, with US-english
character set
20 2130 20 2x 20 2210 70 Connecting Cable,
for controlling peripheral devices,
length 180 cm
536 MK BNC/BNC Video Cable,
length 180 cm
547 S S-Video (Y/C) Connecting Cable,
length 180 cm
20 0400 82 DV Cable, 6 pin to 4 pin,
length 500 cm
Specifications:

Video Output Input Control Output Control Unit (CCU) Power Supply Certified to:

- Composite signal at Keyboard input for title 3.5 mm stereo jack plug - Dimensions: 100-240 VAC, 50/60 Hz IEC 601-1, 601-2-18,
BNC socket generator and camera (ACC 1, ACC 2) 305 x 88 x 254 mm CSA 22.2 No. 601,
- S-Video signal to 4 pin functions to 5 pin DIN (w x h x d) UL 2601, and CE accor-
Mini DIN socket (2x) socket - Weight: ding to MDD, protection
- DV signal 2.7 kg class 1/BF
to 6 pin DV socket
54
Video Accessories for Operating Microscopes
In addition to using the KARL STORZ Endovision®
camera systems with endoscopes, all KARL STORZ
cameras can be connected to other systems, such as
microscopes, colposcopes, and slit lamps. The adap-
tation requires a standardized C-MOUNT connection
on the specific optical system.
Both alternatives have specific advantages:
Direct Adaptation
A direct connection between camera and microscope
has the advantage that no special adaptor systems are
necessary any longer. The direct C-MOUNT connec-
tion is safe, stable, and does not reduce quality. Such a
connection can be made, for example, with the TELE-
CAM® C-MOUNT Camera Head 20 2120 34/20 2121 34
or the TRICAM® C-MOUNT Camera Head 20 2210 34/
20 2211 34 in conjunction with a C-MOUNT micro-
scope adaptor.
Dissection Manual for the Temporal Bone Laboratory
This connection can be made both directly via the
standardized C-MOUNT connection or indirectly via
special quick-adaptors.
Indirect Adaptation
An indirect adaptation between the KARL STORZ
Endovision® camera systems and other optical sys-
tems, for example, a microscope or colposcope with C-
MOUNT connection, may be accomplished with special
quick-adaptors. These quick-adaptors ensure the con-
nection between the standardized endoscope coupling
and the C-MOUNT of the optical system. The advan-
tage of this solution is that the camera can be plugged
directly into the optical system with the endoscope
coupling, without time-consuming threading action.
Such a quick-adaptation is possible with all
KARL STORZ Endovision® cameras.
Example for direct C-MOUNT adaption:
KARL STORZ Endovision® TELECAM® Microscope
Camera Head
Dissection Manual for the Temporal Bone Laboratory
Video Accessories for Operating Microscopes
Adaptor for Direct and Indirect C-MOUNT Adaptation
Camera Heads for quick coupling of Endovision®
camera with C-MOUNT Adaptor 2010 Z:
Indirect C-MOUNT Adaptation
20 2120 30
20 2121 30
2010 Z
2010 Z C-MOUNT Adaptor, allows quick
coupling of Endovision® camera e. g.
with operating microscopes (the
camera’s coupling device is mounted
on the 2010 Z adaptor which fits to an
operating microscope’s C-MOUNT ring)
301513 Optical Beamsplitter 50/50,
for use with ZEISS operating micro-
scope or colposcope
55
Camera Heads for use with TV Adaptor 301677:
Direct C-MOUNT Adaptation
20 2120 34
20 2121 34
20 2200 40
C-MOUNT
Microscope Adaptor
301513
301677
301677 TV-Adaptor, for ZEISS operating microscope
or colposcope, f = 85 mm, for use with
Optical Beamsplitter 301513 and C-MOUNT
Adaptor 2010 Z or TELECAM® C-MOUNT
One-Chip Camera Head
20 2120 34/20 2121 34
20 2200 40 C-Mount Microscope Adaptor for use with
KARL STORZ Endovision TRICAM® C Camera
Head 20 2210 34/20 2211 34
56 Dissection Manual for the Temporal Bone Laboratory

The Compact Documentation Solution

KARL STORZ AIDA™ compact II combines all the required functions for integrated and precise
documentation of endoscopic procedures and open surgeries in a single system.

Data Acquisition
AIDA compact II records still images, video sequences and spoken
comments of findings and intraoperative procedures directly from the
sterile area. Recordings are activated via touch screen, voice control,
footswitch or camera head buttons.
Live display of camera images on the touch screen enables immediate
monitoring and selection of the recorded data.
AIDA compact II:
Voice control

Flexible Review
Before final archiving, the saved data can be viewed or listened to on
the review screen. Data no longer required can be simply deleted.
Individual images, video and audio sequences can be renamed and
given more meaningful names. A pre-defined selection list with key-
AIDA compact II:
words simplifies and speeds up data entry. Furthermore, a comment
Review screen
field is available for entering relevant details of an intervention.
A voice entry of the case report can yet be recorded while viewing
video and image files.

Automated Data Archiving

Once a treatment is completed, AIDA compact II automatically stores the
data on a DVD or CD-ROM, creates a standard report and prints it as an
overview if required.
AIDA compact II: Automatic
creation of standard reports

Multisession and Multipatient

Efficient data archiving is assured as several treatments can be saved
on one DVD, CD-ROM or on an USB stick.

AIDA compact II:

Efficient archiving
Dissection Manual for the Temporal Bone Laboratory 57

Special Features:
● Digital storage of still images, video sequences and audio files

● Digital alternative to video printer, video recorder and dictating machine

● Sterile, ergonomic operation via touch screen, voice control, camera head buttons

and/or footswitch
● Efficient archiving on DVD, CD-ROM or USB stick, multisession and multipatient

● Network storage is possible

● Optional connection to PACS, RIS and HIS

● Automatic creation of standard reports

● Computers and monitors for use in the OR area certified according to EN 60601-1

● Compatible with KARL STORZ Communication Bus (SCB) and OR1™ connect series

20 0406 01U KARL STORZ AIDA™ compact II System

Documentation system for digital archiving of image,
video and audio files in the OR,
power supply: 100/240 VAC, 50/60 Hz
consisting of:
20 0960 20 KARL STORZ AIDA™ control,
with integrated DVD/CD writer
20 0403 77 Frame Grabber Board,
with digital I/Os
20 0403 78 Slot Bracket, for digital I/Os
20 0902 34U PS/2 Compact Keyboard,
US version, with cover
20 0404 02-12 KARL STORZ AIDATM compact II
Software, with voice control and
software protection
20 0402 75 KARL STORZ USB Stick, 512 MB
2 x 20 2210 70 Connecting Cable
20 0901 38 Headset
20 0903 76 Headset Extension Cable,
length 10 m
547 S S-Video (Y/C) Connecting Cable,
length 180 cm
400 A Mains Cord
400 B Mains Cord, US version

Specifications:

Video Systems Signal Inputs Image Formats Video Formats Audio Formats Storage Media

● PAL ● S-Video (Y/C) ● JPG ● MJPEG ● WAV ● DVD+R

● NTSC ● Composite ● BMP ● MPEG1 ● DVD+RW
● MPEG2 ● DVD-R
● DVD-RW
● CD-R
● CD-RW
● USB Stick
58 Dissection Manual for the Temporal Bone Laboratory

KARL STORZ ENDOVISION TRICAM® SL II with ®

– autoclavable
Digital Three-Chip Video Camera – Color Systems PAL, NTSC

20 2210 40 KARL STORZ Endovision TRICAM®, three-chip camera,

color system PAL, with integrated Parfocal Zoom Lens,
f = 14 mm – 28 mm, (2x); with 2 freely programmable buttons,
camera head autoclavable,
including sterilisation tray 39301 ACT.

20 2211 40 KARL STORZ Endovision TRICAM®, three-chip camera,

color system NTSC, with integrated Parfocal Zoom Lens,
f = 14 mm – 28 mm, (2x); with 2 freely programmable buttons,
camera head autoclavable,
including sterilisation tray 39301 ACT.
Camera Control Unit
20 223011U1 TRICAM® SL II Camera Control Unit
color system PAL/NTSC, with integrated KARL STORZ
Communication Bus System ® and integrated Image

Processing Module; power supply: 100–240 VAC, 50/60 Hz;

set, ready for use; without camera head

KARL STORZ ENDOVISION TELECAM® SL II – autoclavable

Digital 1-Chip Video Camera – Color Systems PAL, NTSC

20 2120 40 KARL STORZ Endovision TELECAM®, one-chip camera,

color system PAL, with integrated Parfocal Zoom Lens,
f = 14 mm – 28 mm, (2x); with 2 freely programmable buttons,
camera head autoclavable,
including sterilisation tray 39301 ACT

20 2121 40 KARL STORZ Endovision TELECAM®, one-chip camera,

color system NTSC, with integrated Parfocal Zoom Lens,
f = 14 mm – 28 mm, (2x); with 2 freely programmable buttons,
camera head autoclavable,
including sterilisation tray 39301 ACT
Camera Control Unit
20 2130 11U TELECAM® SL II Camera Control Unit,
color system PAL/NTSC, with integrated Image Processing
Module; power supply: 100–240 VAC, 50/60 Hz;
set, ready for use; without camera head

20 2000 32 KARL STORZ Special Beamsplitter, for use with IMAGE1™,

TRICAM® and TELECAM® camera heads, for simultaneous
viewing by endoscope and monitor screen. The camera head
connector is 120º deflected and can instantly be swiveled to
the desired position.
Dissection Manual for the Temporal Bone Laboratory 59

KARL STORZ TM
DVD-M with SmartscreenTM
Advanced Image and Data Archieving System

Special Features:
● Digital storage of still images,
video sequences and audio files
● Digital alternative to video printers,
video recorders and dictaphone
● Easy and intuitive handling via touch screen,
camera head buttons or footswitch
● Compact design
● Efficient archiving on DVD-R, DVD+R,
CD-R, USB Stick, multisession and
multipatient
● SDI, S-video (Y/C) and composite
video inputs
● Network storage is possible
● All video signals are through-patchable to
the video monitor
● Print-out of still images via ink jet printer
possible
● Compatible with KARL STORZ Communication
Bus (SCB) and OR1™ connect series

20 2045 01-140 KARL STORZ AIDA™ DVD-M with SmartscreenTM,

color system: PAL, NTSC
power supply: 100–240 VAC, 50/60 Hz
consisting of:
20 2045 20-140 KARL STORZ AIDA™ DVD-M, with integrated
DVD/CD writer and integrated touch screen
400 A Mains Cord
400 B Mains Cord, US version
536 MK BNC/BNC Video Cable, length 180 cm
547 S S-Video (Y/C) Connecting Cable, length 180 cm
2 x 20 0400 83 Adaptor, BNC–Cinch
20 0400 84 Serial Connecting Cable, length 20 cm
20 0400 85 DVI Connecting Cable, length 20 cm
20 0400 88 USB-Extension Cable, length 7.5 cm
60 Dissection Manual for the Temporal Bone Laboratory

Cold Light Fountains and Accessories

495 NL Fiber Optic Light Cable,

diameter 3.5 mm, length 180 cm
495 NA Same, length 230 cm
495 ND Same, length 300 cm

Cold Light Fountain HALOGEN 250 twin

20 1133 01 Cold Light Fountain HALOGEN 250 twin,

power supply:
100/120/230/240 VAC, 50/60 Hz,
consisting of:
400 A Mains Cord

Cold Light Fountain XENON NOVA® 175

20 134001 Cold Light Fountain XENON NOVA® 175

power supply:
100 –125 VAC / 220 – 240 VAC, 50/60 Hz
consisting of:
400 A Mains Cord
20 1320 26 Xenon-Spare-Lamp,
only, 175 watt, 15 volt
Dissection Manual for the Temporal Bone Laboratory 61

TFT-Flat Screen Monitors

Multinorm Liquid Crystal Display, PAL and NTSC with automatic switch-over

9415 NNB 15" KARL STORZ TFT Flat Screen,

Wall-mounted with VESA 100 mounting,
color systems PAL/NTSC, resolution max.
1024 x 768, video inputs: (XGA), SDI,
Composite, S-Video, RGBS/VGA, brightness
430 cd/m2, contrast 500:1,
power supply 100 – 240 VAC, 50/60 Hz
consisting of:
9415 NNG 15" TFT Flat Screen
9419 PS External 24 VDC Power Supply
400 A Mains Cord
2x 536 MP BNC/BNC Video Cable,
9415 NN / 9419 NN length 240 cm
547 SL S-Video (Y/C) Connecting Cable,
length 350 cm
20 0403 72 SVGA Connecting Cable,
length 200 cm
Instructions for use on CD-ROM
9415 NN Same, desktop model, with pedestal
9419 NNB 19" KARL STORZ TFT Flat Screen EndoVue
Desktop, color systems PAL/NTSC, resolution
9415 NNB / 9419 NNB max. 1280 x 1024 (SXGA), video inputs: SDI,
Composite, S-Video and RGBS/VGA, brightness
450 cd/m2, contrast 650:1,
power supply 100 – 240 VAC, 50/60 Hz
consisting of:
9419 NNG 19" TFT Flat Screen
9419 PS External 24VDC Power Supply
Mobile Videocart 400 A Mains Cord
2x 536 MP BNC/BNC Video Cable,
length 240 cm
547 SL S-Video (Y/C) Connecting Cable,
length 350 cm
20 0403 72 SVGA Connecting Cable,
length 200 cm
Instructions for use on CD-ROM
9419 NN Same, desktop model, with pedestal

29003 NA Mobile Videocart, consisting of:

29003 NAG Basic Mobile Cart, rides on
4 antistatic double-casters,
2 equipped with locking brakes,
1 shelf fixed, 1 shelf with mains
switch, 1 shelf inclinable,
1 drawer unit with lock, 1 push bar,
with large lumen cable channels
integrated in both columns,
1 set of non-sliding stands,
1 camera mount
29003 PB Power Box with electrical supply
terminal strip with 12 plugs,
12 equipotential plugs
Dimensions:
Mobile Cart:
29003 NA 700 mm x 1280 mm x 686 mm (w x h x d)
shelf: 630 mm x 480 mm (w x d)
caster diameter: 125 mm
62 Dissection Manual for the Temporal Bone Laboratory

Notes: