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At least 37 records · Page 2Linked to original sources
PubMed2006

Digital spectral analysis of the drill-bone acoustic interface during temporal bone dissection: a qualitative cadaveric pilot study.

HYPOTHESIS: To qualitatively assess the different acoustic signatures of an otologic drill burr-bone interface during temporal bone dissection on full thickness calvarial and thin tegmen bone. BACKGROUND: An appreciable change in the sound generated by drilling occurs with progressive thinning of the bone during temporal bone dissection. To date, descriptions of this phenomenon are limited to a handful of subjective characterizations. Using digital power spectral analysis, interpretation of complex functions of time such as acoustic signals can be interpreted. METHODS: Acoustic data recorded from five cadaveric temporal bone dissections were studied using digital spectral analysis. RESULTS: The energy bandwidth concentration was between 5.0 and 7.9 kHz for full thickness bone using the cutting burr. Thin tegmen bone bandwidth concentration was lower, between 3.7 and 7.4 kHz and 3.9 and 6.0 kHz, using cutting and diamond burrs, respectively. Harmonic frequencies for thin tegmen bone-burr signals were 630 Hz. CONCLUSION: There is a consistent, reproducible qualitative difference in the spectral domain of the acoustic signature from the drill burr-bone interface between thick calvarial bone and thin tegmen bone caused by a higher harmonic peak interval and lower energy bandwidth concentration in the thinned tegmen bone-burr interface signal thus concentrating the acoustic signal within a more optimal frequency range for human perception. These results allow for a better understanding of the perceived change in sound with progressive thinning of bone with drilling. In addition, these data may allow the development of more realistic acoustic interfaces in virtual reality temporal bone dissection simulators.

Acoustics↗
PubMed1998

Acute intracranial complications of temporal bone trauma.

Temporal bone trauma can be disastrous for the individual and his or her family. With the increase in violent crime throughout our society, the number of intracranial complications associated with temporal bone injury has increased significantly. Although multiple reports concerning the diagnosis and management of temporal bone trauma have been published, few studies on its intracranial complications have been addressed. In this study, we assessed the cases of 43 patients treated for temporal bone fractures between January 1992 and December 1994. The number of temporal bone fractures increased from 6 in 1992 to 21 in 1994. Twenty-one patients (49%) presented with decreased mental status. Significant alcohol and drug use was documented in 28% and 58% of patients, respectively. The most common radiologic finding was skull and intracranial injury. Thirty-six patients (84%) had at least one abnormal intracranial finding; of these patients, 14 (39%) had more than one abnormal finding on computed tomography. Cerebral midline shift, subarachnoid hemorrhage, subdural hemorrhage, and cerebral edema were the most common radiologic findings. Nineteen patients (44%) required an open neurosurgical procedure, and almost all patients with more than one abnormal radiologic finding underwent neurosurgery (86%). Seven patients required further institutional care after discharge. Four patients died (9% mortality); all the deaths were neurologically related. Mean hospital charges increased from $30,900 in 1992 to $63,000 in 1994.

Adolescent↗
PubMed2002

[Pediatric temporal bone fractures].

Temporal bone trauma are more common nowadays related to sports. We report 2 cases with temporal bone fractures in patients younger than 14 years. They were two male, 9 and 12-year-old respectively, that presented traumatism after accidental falls from lowe height. The first case had a longitudinal temporal bone fracture without hypoacusia or vertigo, whereas the second one had an oblique fracture involving the otic capsule, provoking permanent neurosensorial hearing loss, as well as vertigo and unsteadiness that resolved later, related to a vestibular hyporreflexia. Neither case had facial paresia or paralysis. CT scanning was essential to determine the importance of the trauma. Despite the otic capsule rupture, hearing loss in the second case was only significant over 2 KHz, suggesting a selective cochlear trauma. We present clinical and imaging findings, as well as correlation of audiological and vestibular alterations, reviewing the clinical presentation of temporal bone trauma in children.

Cerebrospinal Fluid Otorrhea↗
PubMed1994

Preparation of a temporal bone exhibit.

Temporal bone dissection forms an important aspect in the training of an otolaryngologist. The more dissection one does the more confident one is in the operating room. The aim of this paper is to advise in the preparation of temporal bones for the purpose of display, exhibition or competition. The practical aspects of dissection are deliberately avoided concentrating on the selection of bones pre- and post-dissection, preparation of the bones, fixing and display of vessels and nerves and also mounting and lighting for exhibition purposes. The temporal bone laboratory should be well equipped with a microscope, a power drill with a range of cutting and polishing burrs, a range of fine instruments, a suction machine with different sizes of suction tips, water source, a place to store the bones etc., thus creating an ideal environment for temporal bone dissection.

Dissection↗
PubMed1986

Tegmental and petromastoid defects in the temporal bone.

Fifty temporal bones were examined using the temporal bone dissecting microscope. 34 per cent were found to have defects in the tegmen and petromastoid segments, resulting in communications between the cranial cavity and the middle ear cleft. However, no defects were found in the overlying dura. This may have an important bearing on the intracranial spread of infection from the middle ear cleft, even in the absence of any bony destruction due to chronic middle ear disease.

Ear Diseases↗
PubMed1985

Paget's disease and the temporal bone--a clinical and histopathological review of six temporal bones.

Paget's disease of bone occurs more commonly in the elderly and has been reported to involve the temporal bone in 30% of those afflicted. The clinical and histopathological features of six temporal bones from three patients with this disease are reported and the relevant literature reviewed. The effect of Paget's disease on the middle ear structures was more variable than its extension into the otic capsule. Pagetic involvement of the otic capsule was observed in five temporal bones. One patient had bilateral asymptomatic neurofibromas in the eighth cranial nerve. the potential mechanisms responsible for the conductive deafness, the sensorineural deafness and vestibular dysfunction associated with Paget's disease are discussed.

Age Factors↗
PubMedDate not supplied

High resolution CT scan of temporal bone fractures: association of facial nerve paralysis with temporal bone fractures.

This radiologic study analyzed high resolution computed tomographic (CT) scans of 22 patients with temporal bone fractures. There were 19 males and three females. Fifteen of 22 had clinical evidence of facial nerve injury ranging from mild paresis to complete paralysis. The high resolution CT scan analysis identified a characteristic fracture of the temporal bone in every patient with facial nerve injury. A high percentage of these fractures (68%) could be classified as mixed and did not fall into a longitudinal or transverse fracture category. The characteristic fracture extends from the petrotympanic fissure at the glenoid fossa to the anterior inferior aspect of the medial bony external auditory canal. It resumes at the superior aspect of the external auditory canal (scutum) extending laterally along the external canal wall. If the vector force of the fracture is projected medially, it will cross the facial nerve in its horizontal portion. Often, the evaluation of trauma patients with routine CT scans for central nervous system (CNS) (brain) evaluation is inadequate for evaluation of temporal bone fractures. A high resolution CT scan should be performed when clinical criteria warrant its use. It is recognized that the incidence of facial nerve injury may be higher in this select population.

Adolescent↗
PubMed1991

[A case of bilateral sudden hearing loss and vertigo caused by bilateral temporal bone metastasis from pancreatic carcinoma--comparison of clinical findings and temporal bone pathological findings].

We report temporal bone pathology in a 25-year-old man with bilateral temporal bone adenocarcinoma which was caused by metastasis from a primary lesion in the pancreas. The initial symptoms began with vertigo and headache and the patient noticed left hearing loss in the left ear on the following day. A few days later, he noticed hearing loss in the right ear, and bilateral hearing was totally lost within two weeks of the onset. In addition to severe bilateral sensorineural hearing loss, left IInd, bilateral Vth and VIIIth cranial nerve paralysis occurred. Brain CT showed multiple metastatic lesions in the brain. The patient's general condition rapidly deteriorated, and he died of acute pneumonia on the 42nd day after onset. At autopsy it was revealed adenocarcinoma of the tail and body of the pancreas and its metastasis to the brain and meninges. Pathological study of the temporal bone showed infiltration of carcinomatous cells along the VIIth and VIIIth nerves in the bilateral internal auditory canals.

Adenocarcinoma↗
PubMedDate not supplied

Sudden deafnfess of vascular origin: a human temporal bone study.

Temporal bone changes are described in a 57-year-old man who had sudden onset of dizziness and unilateral deafness two months before death. The patient suffered from hypertension, and congestive and renal failure. At autopsy, subarachnoid hemorrhage with punctate cortical hemorrhages and arteriolar thickening involved the right superior cerebellar hemisphere. The pathological changes involved primarily the right cochlea, saccule and posterior ampulla, and were consistent with vascular embarrassment of the temporal bone of two months duration. The cochlea demonstrated total loss of the organ of Corti and severe degenerative changes of the stria vascularis, spiral ligament, outer sulcus cells and distal cochlear nerve fibers. The saccule demonstrated loss of its macula and nerve fibers. The posterior ampulla showed evidence of previous rupture of its membranous wall with fibrosis and beginning bone formation. Fresh hemorrhage, present in some areas of both temporal bones, was related to the patient's terminal subarachnoid hemorrhage.

Deafness↗
PubMed1988

Non-Hodgkins lymphoma of the temporal bone.

The temporal bone may be involved by primary or secondary neoplasms. The latter are uncommon but well documented in the literature, the usual primary sites being breast, kidney, lung, stomach, larynx and prostate (Schuknecht et al., 1968). Lymphoma rarely invades the temporal bone and is usually confined to the lymphoreticular system and gastrointestinal tract. A case of non-Hodgkins lymphoma of the temporal bone is presented.

Aged↗
PubMed1995

Non-osteitic complications of therapeutic radiation to the temporal bone.

The temporal bone often falls within the field of radiation for head and neck tumors. Whereas osteoradionecrosis is well recognized as the end-stage complication of radiation to the temporal bone, serious non-osteitic complications can also occur, and these are important because the ear is an organ of special sense. Radiation causes changes in the specialized tissues of the ear that can impair function and influence therapeutic decisions. The purpose of this article is to review the non-osteitic effects of radiation on the ear. A series of cases is presented that illustrate the spectrum of non-osteitic complications of radiation therapy. External canal stenosis, otitis media with effusion, chronic suppurative otitis media with or without cholesteatoma, sensorineural hearing loss, vestibular impairment, and facial nerve paralysis are described. Management should be guided by an understanding of the pathogenesis of these complications. The authors believe that non-osteitic complications of therapeutic radiation to the temporal bone are relatively common and warrant increased recognition.

Adult↗
PubMed1997

Clinicopathologic study of leptomeningeal carcinomatosis involving the temporal bone.

The temporal bone pathology of a 71-year-old man with bilateral sensorineural hearing loss and facial paralysis caused by diffuse metastatic leptomeningeal carcinomatosis is described. The origin of this malignant disease was an extremely rare entity, a transitional cell carcinoma of the renal pelvis. Histopathologic study of the temporal bone demonstrated that tumor cells filled the internal auditory meatus, infiltrated into the Rosenthal's canals, and reached the scala tympani of the basal turn of the bilateral cochleas. The vestibulocochlear nerve and facial nerve trunks in the internal auditory meatus had been destroyed by the bilateral tumor invasion. Case reports of temporal bone metastases of leptomeningeal carcinomatosis published since 1965 were reviewed. In leptomeningeal carcinomatosis, it is suggested that tumor cells infiltrate the internal auditory meatus of both ears simultaneously from the cerebrospinal fluid, involving the seventh and eighth nerve trunks, and then cause bilateral sensorineural hearing loss and facial paralysis.

Aged↗
PubMed1995

[3-dimensional imaging of temporal bone structures using spiral CT. Initial results in normal temporal bone anatomy].

3D reconstruction of the temporal bone using spiral CT techniques was performed in 51 patients with various otological diseases during routine clinical work evaluation. The 3D display was optimized by a reduced study time and improved detail accuracy by special algorithms. We were able to demonstrate comprehensively in a 3D mode the normal anatomy of the inner ear and adjacent middle ear structures, such as the modiolus of the cochlea, the semicircular canals, the cochlear and vestibular aqueduct and the ossicles. We suggest routine 3D delineation of the substructures of the temporal bone prior to otologic surgery to provide the surgeon with a 3D view of individual anatomy and specific otosurgical sites.

Cochlea↗
PubMed1992

Temporal bone fractures: longitudinal or oblique? The case for oblique temporal bone fractures.

Classical descriptions and illustrations of temporal bone fractures are misleading. Both oblique and longitudinal fractures produce a similar fracture line in the middle cranial fossa; however, externally, they are different. Oblique fractures cross the petrotympanic fissure while longitudinal fractures run within it. In a study of 150 temporal bone fractures, the majority were oblique. An array of fracture planes accounts for most of the fractures observed. Depending on the direction of trauma, fracture planes rotate around an anteroposterior axis. When they approach the horizontal (axial) plane, they result in oblique fractures. True longitudinal fractures are rare. They are vertical and perpendicular to the oblique planes.

Adolescent↗
PubMedDate not supplied

Aneurysmal bone cyst of the temporal bone.

Aneurysmal bone cysts are benign fibrosseous lesions of the bone that are rarely detected in the temporal bone. Seventeen cases of aneurysmal bone cysts with histological confirmation involving the temporal bone were reported in the literature. We report a case of left temporal aneurysmal bone cyst in a 52-year-old male with the clinical findings of periauricular painful swelling, decreased hearing, and facial paralysis. A magnetic resonance image of the patient showed a well-circumscribed multi-loculated expansile lesion of the left temporal bone during the first admission to the hospital. The lesion recurred 1 year after the subtotal resection with a more solid appearance. In addition, we review the literature for these rare lesions.

Bone Cysts, Aneurysmal↗
PubMed2006

Role of radiotherapy in a recurrent aneurysmal bone cyst of the temporal bone: case report.

OBJECTIVE AND IMPORTANCE: A rare case of aneurysmal bone cyst (ABC) of the temporal bone is presented which, following recurrence after surgery, was successfully treated with radiotherapy. The role of radiotherapy in such cases is reviewed. CLINICAL PRESENTATION: A 30-year-old man presented with a recurrent swelling and pain in right temporal region following surgery for ABC at that site. INTERVENTION: Local radiotherapy to a dose of 31.5 Gy in 18 fractions over 3.5 weeks was delivered to the site of recurrence. The patient had a near total regression of the ABC as evident clinically and on radiological images. CONCLUSION: To the best of our knowledge, radiation for the recurrent ABC at the temporal bone has not been described in the literature. However, in view of the response evident in this patient, radiotherapy seems to be effective for recurrent cases of ABC at the temporal bone and a dose of around 30 to 36 Gy could be effectively delivered with satisfactory results.

Adult↗