Prussak's space


In human anatomy, Prussak's Space is the small middle ear recess, bordered laterally by the flaccid part of Shrapnell's membrane, superiorly by the scutum and lateral malleal ligament, inferiorly by the lateral process of the malleus, and medially by the neck of the malleus. From the neck of the malleus, the anterior malleolar fold and the anterior ligament arise, demarcating Prussak's space anteriorly. Ventilation of Prussak's space is only possible posteriorly above the posterior malleus fold.
It communicates with the posterior pouch of von Troltsch.
It is named after the Russian otologist Alexander Prussak.

Boundaries

Prussak's space is important because it is a site for pars flaccida acquired cholesteatoma formation. A cholesteatoma forms when there is a deep retraction pocket in the tympanic membrane. The lining of the tympanic membrane, which is skin, is shed, but if the membrane is retracted it gets trapped. The debris collects and enlarges and ultimately forms a cholesteatoma. This cholesteatoma, in turn, can erode the middle ear ossicles, facial nerve, inner ear and even involve the brain.
From Prussak's space, located in the epitympanum, cholesteatoma patterns of spread are: