Herald Cell: The Gateway to Posterior Tympanotomy—A Cadaveric Study

  • Anup Singh
  • Rajeev KumarEmail author
  • Prem Sagar
Original Article


Posterior tympanotomy is the avenue to the facial recess of the middle ear from mastoid antrum. The entry into the facial recess in many cases is heralded by a distinct air cell before approaching the facial-chordal plane. The current study was undertaken to determine the prevalence of this ‘Herald Cell’ in an adult cadaveric population. It was a human cadaveric temporal bone dissection study. The bones were dissected to carry out cortical mastoidectomy and posterior tympanotomy using standard otologic drills under microscopic visualization (Leica M320 F12). Appropriate snapshots were taken to document the presence or absence of Herald cell. A total of 51 temporal bones were dissected (26 right, 25 left sided). The Herald cell was found to be present in 22 bones (43.1%). Herald cell, when present, is a convenient and reliable landmark to carry out a safe posterior tympanotomy.


Temporal bone Dissection Anatomic landmarks Facial nerve Chorda tympani nerve 



The authors acknowledge their deepest gratitude to those who donated their bodies for the scientific purpose.


Research Section, All India Institute of Medical Sciences, New Delhi, India, provided the grant for the research work as a part of intramural project work. (Grant Number-F.8-368/2015/RS).

Compliance with Ethical Standards

Conflict of interests

The authors declared that they have no conflict of interest.

Ethical Approval

Ethical approval was obtained from the Institutional Ethical Committee.


  1. 1.
    Öztürk K, Göde S, Çelik S, Orhan M, Bilge O, Bilgen C et al (2016) Revisiting the anatomy of the facial recess: the boundaries of the round window exposure. Balkan Med J 33(5):552–555CrossRefGoogle Scholar
  2. 2.
    Mangus B, Rivas A, Tsai BS, Haynes DS, Roland JT (2012) Surgical techniques in cochlear implants. Otolaryngol Clin North Am 45(1):69–80CrossRefGoogle Scholar
  3. 3.
    Beltrame AM, Todt I, Sprinzl G, Profant M, Schwab B (2014) Consensus statement on round window vibroplasty. Ann Otol Rhinol Laryngol 123(10):734–740CrossRefGoogle Scholar
  4. 4.
    Adoga SA, Maan ND, Ugwu BT, Umar BM, Nwaorgu GO (2011) Temporal bone dissection skill: a necessity for life otologic surgeries? Indian J Otol 17:71–74CrossRefGoogle Scholar
  5. 5.
    Bojrab DI, Balough BJ, Crane BT (2010) Surgical anatomy of the temporal bone and dissection guide. In: Gulya AJ, Minor LB, Poe DS (eds) Glasscock-Shambaugh surgery of the ear, 6th edn. People’s Medical Publishing House, Shelton, pp 771–789Google Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology and Head and Neck Surgery, Room No.-4057, 4th Floor, Teaching BlockAll India Institute of Medical Sciences, New DelhiNew DelhiIndia

Personalised recommendations