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The fourth item was "remove bone on the anterior medial surface of the fallopian canal just below the pyramidal process".
To facilitate visualization of the round window niche which is the primary landmark for cochleostomy or round window electrode insertion, it is usually necessary to remove bone on the anterior medial surface of the fallopian canal just below the pyramidal process [ 12, 26– 28] because the round window niche is located posteriorly in the mesotympanum.
The items that showed the highest difference between the expert and resident groups were "remove bone on the anterior medial surface of the fallopian canal just below the pyramidal process" (mean difference 1.72, 95% CI 1.15 to 2.30, P < 0.001) and "facial recess is opened to visualize the round window niche" (mean difference 1.51, 95% CI 0.78 to 2.24, P < 0.001).
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a Patient with a complete disengagement of the pyramidal process from the pterygoid plates.
In the case of a partial disengagement of the pyramidal process from the pterygoid notch, the width of the opening was measured from the pyramidal process to the pterygoid plate adjacent to the opening (Fig. 7b).
b Patient with a partial disengagement of the pyramidal process from the pterygoid plates in the left pterygopalatine suture; the opening is present between the pyramidal process and the medial pterygoid plate.
Pterygopalatine suture was split in its lower region by MSE, as the pyramidal process was pulled out from the pterygoid process.
The width depends on the size of the pyramidal process of the palatine bone that presents large variability in shape and size among the population [30].
Furthermore, the axial palatal section cuts the pterygopalatine suture in an area where the pyramidal process of the palatine bone articulates with the pterygoid notch located between the lateral and the medial plate of the pterygoid process (Fig. 8).
In addition, there are no gaps between the lateral and medial plates of the pterygoid processes since the pterygoid notch is occupied by the pyramidal process of the palatine bone (Fig. 8).
The articular possesses a large pyramidal process as the medial extension of the glenoid region.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com