Surgical anatomy and pathology of the round window

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Abstract
The surgical anatomy and pathology of the round window in 292 serially sectioned temporal bones were studied. The surgical approach to the round window was discussed considering the anatomy. Obliteration of the round window niche occurred as a congenital anomaly in otosclerosis, chronic otitis media and as an end result in suppurative labyrinthitis. Obliteration of the window was associated with a significant hearing loss, contary to findings in animals. In chronic otitis media the round window was a pathway for the spread of infection to the labyrinth. Perilymphatic precipitates adjacent to the window in some ears implied certain inflammatory products may enter the scala tympani through the round window, leading to high tone sensorineural hearing loss.