Cadaveric Study of Crista Fenestra: Revisited

OBJECTIVES: Since there is great confusion in the literature about the anatomy and terms of the crista fenestra (CF) and the crista semilunaris, this paper is confined to the anatomy of the inferior margin of the round window (RW). METHODS: This study was carried out on 20 cadaveric temporal bones. We measured the maximal height of the RW and the maximum height of the inferior bony edge of the RW, (termed CF type A), in this study. The ratio of the maximum height of CF type A to the maximum height of the RW was calculated. After drilling the CF type A, the scala tympani was visualized using a sialendoscope, and any bony projection in the inferior wall of the scala tympani just behind the round window membrane (RWM) was assessed and reported (termed CF B in this study). RESULTS: We identified CF type A in 19/20 of cases (95%), and it was absent in only 1 case (5%). Its height ranged from 0.228 to 1.329 mm with an average of 0.604±0.347 mm. The percentage of CF type A to RW ranged from 19 to 75%, with an average of 42%. CF type B was present in only 2 specimens (10%). CONCLUSION: CF type A occupied a significant part of the RW in most specimens, and therefore its drilling was essential in a large percentage of cases. CF type B (inside the scala tympani) was present in 10% of the temporal bone samples, and curettage had to be done in these cases.