Relationship of the utriculus and sacculus to the stapes footplate: Anatomic implications for sound- and or pressure-induced otolith activation

One hundred thirty human temporal bones that were sectioned in the vertical plane were examined to evaluate the relationship between the stapes footplate and the otolith organs. The shortest distance between the footplate and the utriculus was 0.58 +/- 0.10 mm in the posterior third of the oval window, 1.04 +/- 0.20 mm in the middle third, and 1.51 +/- 0.20 mm in the anterior third. The distance from the sacculus to the footplate was 1.33 +/- 0.20 mm in the middle third of the oval window and 1.31 +/- 0.18 mm in the anterior third. Membranous connections extending between the utriculus and the footplate were found in 26% of temporal bones. These membranous connections in coexistence with additional anatomic factors such as stapes hypermobility and/or dehiscence of bone within labyrinthine structures may predispose patients to sound- and/or pressure-induced otolith activation. The findings may have implications for different causes of the Tullio phenomenon.