Hostname: page-component-6b989bf9dc-lb7rp Total loading time: 0 Render date: 2024-04-14T23:11:11.868Z Has data issue: false hasContentIssue false

X-ray microtomography study of otic capsule deficiencies: three-dimensional modelling of the fissula ante fenestram

Published online by Cambridge University Press:  05 August 2015

J W Lee*
Kolling Deafness Research Centre, Royal North Shore Hospital, University of Sydney Medical School, Australia
P Sale
Kolling Deafness Research Centre, Royal North Shore Hospital, University of Sydney Medical School, Australia
N P Patel
Kolling Deafness Research Centre, Royal North Shore Hospital, University of Sydney Medical School, Australia
Address for correspondence: Dr J Lee, Kolling Deafness Research Centre, Level 12, Kolling Building, Royal North Shore Hospital, St Leonards, NSW 2065Australia E-mail:



The postulated sites of perilymph fistulae involve otic capsule deficiencies, in particular, at the fissula ante fenestram. Histological studies have revealed this to be a channel extending from the middle ear, and becoming continuous with the inner ear medial to the anterior limit of the oval window. The relationship between a patent fissula and symptoms of perilymph fistula is contentious.


The understanding of the anatomy of the fissula ante fenestram is incomplete. Histopathology is inherently destructive to the delicate ultrastructure of the middle and inner ear. Conversely, X-ray microtomography allows non-destructive examination of the otic capsule. In this study, we used X-ray microtomography to characterise the fissula ante fenestram.

Materials and methods:

We imaged cadaveric temporal bones with X-ray microtomography. We used the Avizo Fire (Visualization Science Group, Merignac Cedex, France) software to perform post-processing and image analysis.


Three-dimensional modelling of the fissula ante fenestram allowed stratification into four forms: rudimentary pit; partial fissula; complete occluded fissula; and complete patent fissula.


X-ray microtomography showed that the fissula ante fenestram is present in various forms from rudimentary pit to complete deficiency of the otic capsule. This understanding may have implications for otologic surgery and clinical diagnosis of perilymph fistula.

Main Articles
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1Kohut, RI. Perilymphatic fistulae: more than a century of notions, conjectures, and critical studies. Am J Otol 1992;13:3840Google ScholarPubMed
2Friedland, DR, Wackym, PA. A critical appraisal of spontaneous perilymphatic fistulas of the inner ear. Am J Otol 1999;20:261–79Google ScholarPubMed
3Vartiainen, E, Nuutinen, J, Karjalainen, S, Nykänen, K. Perilymph fistula – a diagnostic dilemma. J Laryngol Otol 1991;105:270–3CrossRefGoogle ScholarPubMed
4Harada, T, Sando, I, Myers, EN. Microfissure in the oval window area. Ann Otol Rhinol Laryngol 1981;90:174–80CrossRefGoogle ScholarPubMed
5Okano, Y, Myers, EN, Dickson, DR. Microfissure between the round window niche and posterior canal ampulla. Ann Otol Rhinol Laryngol 1977;86:4957CrossRefGoogle ScholarPubMed
6Anson, BJ, Donaldson, JA. Surgical Anatomy of the Temporal Bone and Ear. Philadelphia: W. B. Saunders; 1973Google Scholar
7Uzun, H, Curthoys, IS, Jones, AS. A new approach to visualizing the membranous structures of the inner ear – high resolution X-ray micro-tomography. Acta Otolaryngol 2007;127:568–73CrossRefGoogle ScholarPubMed
8Minor, LB. Labyrinthine fistulae: pathobiology and management. Curr Opin Otolaryngol Head Neck Surg 2003;11:340–6CrossRefGoogle ScholarPubMed
9Shea, JJ. The myth of spontaneous perilymph fistula. Otolaryngol Head Neck Surg 1992;107:613–6CrossRefGoogle ScholarPubMed
10Kohut, RI, Hinojosa, R, Howard, G, Ryu, JH. The accuracy of the clinical diagnosis (predictability) of patencies of the labyrinth capsule (perilymphatic fistulas): a clinical histopathologic study with statistical evaluations. Acta Otolaryngol Suppl 1995;520:235–7CrossRefGoogle ScholarPubMed
11Seltzer, S, McCabe, BF. Perilymph fistula: the Iowa experience. Laryngoscope 1986;96:3749CrossRefGoogle ScholarPubMed
12Kohut, RI, Hinojosa, R, Ryu, JH. The histologic characteristics of the core of the fissula ante fenestram. Acta Otolaryngol Suppl 1991;111:158–62CrossRefGoogle Scholar
13Anniko, M, Lundquist, PG. The influence of different fixatives and osmolality on the ultrastructure of the cochlear neuroepithelium. Arch Otorhinolaryngol 1977;218:6778CrossRefGoogle ScholarPubMed
14Dawes, JD, Pearman, K, Kochilas, X. Patent fissula ante fenestram. J Laryngol Otol 1983;97:357–60CrossRefGoogle ScholarPubMed
15Bast, TH. Development of the otic capsule. II. The origin, development and significance of the fissula ante fenestram and its relation to otosclerotic foci. Arch Otolaryngol 1933;18:120CrossRefGoogle Scholar
16Anson, BJ, Cauldwell, EW. Stapes, fissula ante fenestram and associated structures in man. IV. From foetuses 75 to 150 mm in length. Arch Otolaryngol Head Neck Surg 1943;37:650–71CrossRefGoogle Scholar
17Anson, BJ, Martin, J. Fissula ante fenestram: its form and contents in early life. Arch Otolaryngol Head Neck Surg 1935;21:303–23CrossRefGoogle Scholar
18Anson, BJ, Wilson, JG. The fissula ante fenestram in an adult human ear. Anat Rec 1933;56:383–93CrossRefGoogle Scholar
19Wilson, JG. Fissula ante fenestram and the adjacent tissue in the human otic capsule. Acta Otolaryngol 1935;22:382–92CrossRefGoogle Scholar
20Perozzi, L. Ricerche anatomiche intorno alla capsula del labirinto [in Italian]. Arch Ital Otol Rinol Laringol 1921;31:214, 321, 353Google Scholar
21Cole, GG. Validity of spontaneous perilymphatic fistula. Am J Otol 1995;16:815–19Google ScholarPubMed
22Grundfast, KM, Bluestone, CD. Sudden or fluctuating hearing loss and vertigo in children due to perilymph fistula. Ann Otol Rhinol Laryngol 1978;87:761–71CrossRefGoogle ScholarPubMed