Middle ear surgeons will appreciate seeing the angle between the capitulum and the TM is not 90 degrees. The position of the anterior process of the malleus in the anterior malleolar ligament can be seen lateral to the chorda. The potential improved exposure of the posterior tympanic wall by first removing bone anterior to the chorda and then anterior to the facial nerve is demonstrated.  The burrs shown are 2mm diameter. The sinus tympani is shown with its anatomic relationships.

Cochlear implant surgeons are challenged with the need to visualize the cochlea through the facial recess. The apex may need to be accessed if the basal turn is obstructed. The apex can be seen beneath the mid-belly of the tensor tympani muscle. The level of the apex can be predicted by the plane of the stapes footplate. A drill path over the capitulum and under the cocheariform process is shown. The facial recess and cochlea dimensions are shown relative to 1, 1.5 and 2mm burrs.