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PubMed1999

Angiocentric lymphoma involving the temporal bone in a child.

Involvement of the temporal bone in patients with malignant lymphomas is very rare. Most of the reported cases have been clinically asymptomatic and were diagnosed only by post-mortem examinations. We present a nasal, paranasal, nasopharyngeal lymphoma that occurred in a 12-year-old child and also involved the temporal bone. Clinical presentation began with bilateral chronic otitis media. Histopathologically, tumor was found to be an angiocentric lymphoma of B-cell origin. Association with Epstein-Barr virus could not be demonstrated. Despite combination chemotherapy (with cyclophosphamide, vincristine, doksorubicine, prednisolone, L-asparaginase, cytosine arabinoside, metotraxate) and radiotherapy (to 40 Gy), disease progressed locally as well as to cervical lymph nodes and the lungs.

Child↗
PubMed1985

Middle ear surgery in fibrous dysplasia of the temporal bone.

Fibrous dysplasia of the temporal bone is uncommon. When it does occur, surgery may be necessary because of cholesteatoma or chronic infection behind bony obstruction of the external auditory canal. Cosmetic surgery may also be performed because of bony deformity. When a surgical procedure is undertaken for hearing improvement, special problems may be encountered. The case presented illustrates middle ear pathologic changes found with fibrous dysplasia and specific surgical difficulties.

Adolescent↗
PubMed2000

Xanthoma of the temporal bone: case report.

OBJECTIVE AND IMPORTANCE: Xanthomas of the cranium that are not accompanied by endocrine or metabolic abnormalities are extremely rare. It is very important to understand the pathological features of this disease, for differential diagnosis from other diseases. CLINICAL PRESENTATION: A 62-year-old woman presented to the hospital with headaches. Cranial x-rays revealed bone destruction in the right temporal bone, with osteosclerosis in the area surrounding the lesion. In computed tomographic scans, the bone cortex was intact and the diploë was dilated because of the large mass of the lesion. T1-weighted magnetic resonance imaging findings were heterogeneous, with areas of hypo- and isointensity; T2-weighted magnetic resonance imaging findings were also heterogeneous, with areas of hypo- and hyperintensity. INTERVENTION: Total removal of the tumor was performed, followed by cranioplasty using artificial bone. DIAGNOSIS: Histologically, lipid-containing foamy cells were dense and a cholesterin granuloma was observed. There was no reason to infer other diseases, and a diagnosis of xanthoma of the temporal bone was reached. CONCLUSION: Xanthomatous lesions are observed in various pathological conditions, including malignant diseases. Xanthomas are benign lesions and the prognoses for patients with these lesions are satisfactory, even after partial excision. Therefore, it is quite important to distinguish xanthomas from other diseases that produce xanthomatous lesions.

Diagnosis, Differential↗
PubMedDate not supplied

Temporal bone involvement by prostatic adenocarcinoma: report of two cases and review of the literature.

Although axial bone and cranial metastases are common in patients with prostatic carcinoma, temporal bone involvement is rare. We report 2 cases of prostatic adenocarcinoma with temporal bone metastasis and review the relevant literature. One case had a 3-year history of a prostatic carcinoma, whereas in the second case the temporal bone metastasis was the initial presentation. Awareness of the possibility of temporal bone involvement by prostate carcinoma and application of immunohistochemical studies will help to arrive at the correct diagnosis.

Adenocarcinoma↗
PubMed1982

Fluctuating hearing loss and recurrent vertigo in otosclerosis. An audiologic and temporal bone study.

This report summarizes audiologic and temporal bone findings in a 47-year-old white female with recurrent attacks of vertigo, tinnitus, and bilateral hearing loss. A series of audiograms, obtained over a 15-year period, showed a fluctuating mixed (sensorineural and conductive) hearing loss with a relatively flat configuration in the left ear and a relatively stable, mild sensorineural loss with a sloping contour in the right ear. Temporal bone studies revealed the existence of otosclerotic foci bilaterally. In the left ear, the otosclerotic focus has grown close to the utricular and lateral ampullary nerves, displaced and ankylosed the stapedial footplate, invaded the endosteal zone (1,000-2,000 Hz area), and deformed the lateral cochlear wall. In the right ear, the otosclerotic invasion was limited to the inferior portion on the promontory (vestibular cecum) and round window niche.

Audiometry↗
PubMed1993

Potter's syndrome: a temporal bone histopathological study.

Histopathological findings in seven temporal bones from four infants diagnosed as Potter's syndrome are described. The infants were labelled as Potter's syndrome after autopsy confirmed bilateral renal agenesis. Extrarenal manifestations included pulmonary hypoplasia and facial anomalies. The middle ear volume in infants with Potter's syndrome remained unchanged with age resulting in a significantly higher percentage of residual middle ear mesenchyme in these infants as compared to normal infants. Dehiscence of the facial nerve was seen in all the temporal bones studied. One ear showed the presence of eosinophilic effusion in the endolymphatic sac, an underdeveloped malleus and a wide facial nerve canal. The inner ear structures showed no significant anomalies except for the absence of the organ of Corti in the basal turn of the cochlea in one of the ears.

Abnormalities, Multiple↗
PubMed2001

Temporal bone histopathological study of Noonan syndrome.

Four temporal bone specimens, obtained from three individuals 1--6 years of age with Noonan syndrome (NS), were studied histopathologically. All four specimens were accompanied by similar inner ear abnormalities including the reduced number of spiral ganglion cells, enlarged lateral semicircular canal, and dislocated endolymphatic sac and vestibular aqueduct. The mean population of spiral ganglion cells (15,699 cells) was approximately half of those (32,978 cells) in four age-matched control cases. In addition, they had several middle ear abnormalities including the remaining mesenchyme and dehiscence of the facial canal. To our knowledge, this is the first report to describe the histopathological temporal bone findings in patients with NS. We discuss the implications of the observed abnormalities with regard to clinical issues.

Child↗
PubMed1995

Radiotherapy in the management of temporal bone chemodectoma.

Forty patients with 42 temporal bone chemodectomas were treated with radiotherapy alone (37 tumors) or subtotal resection and irradiation (5 tumors) at the University of Florida between 1968 and 1992. Thirty-three lesions were previously untreated, whereas 9 had undergone prior treatment (surgery, 6 lesions; radiotherapy, 1 lesion; or both, 2 lesions) and were treated for locally recurrent disease. All 3 patients who received prior radiotherapy had been treated at other institutions. Patients had minimum follow-up times as follows: 2 years, 40 patients (100%); 5 years, 31 patients (78%); 10 years, 21 patients (53%); 15 years, 16 patients (40%); 20 years, 9 patients (23%); and 25 years, 2 patients (5%). The local control rate at 20 years, calculated by the Kaplan-Meier product-limit method for the overall group of 42 lesions, was 89%. The likelihood of cause-specific survival at 20 years was 94%. The incidence of treatment-related complications was acceptable. We conclude that irradiation offers a high probability of tumor control with relatively minimal risks for patients with chemodectomas of the temporal bone.

Journal Article↗
PubMed2004

Large intraosseous hemangioma of the temporal bone in a child.

Hemangiomas of the temporal bone are extremely uncommon tumors, predominantly arising in the area of the geniculate ganglion and the internal auditory canal and affecting mainly middle-aged adults. We present a 6-year-old boy who had suffered from recurrent infections of the left ear associated with a slight conductive hearing loss, but without facial nerve dysfunction. Using high-resolution computed tomography and gadolinium-enhanced magnetic resonance imaging, we detected an unusually large 32 x 32 x 24-mm mass of the left temporal bone occupying the entire mastoid. Histopathologically, a capillary hemangioma was diagnosed. The tumor was removed surgically by a transmastoid approach. We present a thorough review of the literature, focusing on the clinical and radiologic features, as well as the pathogenesis of intratemporal vascular lesions.

Child↗
PubMed1994

[High resolution magnetic resonance tomography of the temporal bone].

Computed tomography (CT) has long been the method of choice for investigations of the temporal bone. Advances in high resolution magnetic resonance imaging (MRI) enabled MRI of the temporal bone. The purpose of this study was to assess detailed reconstruction of the anatomy of the temporal bone by MRI. Healthy volunteers were examined on a 1T MR whole body scanner (Impact, Siemens, Erlangen, Germany). A Helmholtz-configurated head coil was used. A T1-weighted 2D-FLASH sequence (TR = 400 ms, TE = 10 ms, 90 degrees flip angle, 2 mm slice thickness, 180* 256 matrix, 160 mm FOV) was performed pre- and postcontrast as well as a T2-weighted turbo spin echo sequence (TR = 6300 ms, TE = 112 ms, 3 mm slice thickness, 200 mm matrix, 200 mm FOV). A sagittal and an angulated paraxial projection, parallel to the nasopharyngeal edge of the clivus, were chosen. We suceeded in imaging the facial nerve along its entire course, including the geniculate ganglion and the greater superficial petrosal nerve, the cochlear nerve and the vestibular nerve (superior and inferior part). The facial nerve was visualised continuously from the cerebellopontine angle to the foramen stylomastoideum. The delineation of the different turns of the cochlea, the vestibule and the semicircular canals was excellent. High resolution MRI promises to be of great value in the diagnosis of the temporal bone.

Cochlea↗
PubMed1992

Evaluation and management of temporal bone arachnoid granulations.

The diagnosis and evaluation of temporal bone arachnoid granulations (AGs) is based on characteristic bone defects in the posterior or middle fossa surfaces of the temporal bone in adult patients with persistent serous otitis media or septic meningitis following acute otitis media. The cerebrospinal communication caused by AGs should be repaired by a middle fossa craniotomy (middle fossa AGs) or an intact canal wall mastoidectomy (posterior fossa AGs) to preserve normal sound transmission. In adult patients with chronic mastoiditis, the dural defect of an AG may permit intracranial extension of the chronic inflammatory process. This rare extension of disease should be considered in patients who have chronic ear inflammation and severe pain or signs of intracranial disease.

Adolescent↗
PubMed1993

Severe radionecrosis of the temporal bone.

Severe radionecrosis of the temporal bone is a potentially lethal condition which still occurs despite improvements in radiotherapy. A series of seven such cases is presented to outline the varied clinical features and management of this disease.

Adult↗
PubMed1998

[Correlations between topography of the main structures of the temporal bone and the location of the sigmoid sinus].

Topographical relations between main structures of the temporal bone are important for otosurgeons. There were reports aiming at establishing some laws in the temporal bone building, that would allow to anticipate the location of the important structures in the temporal bone. It is obvious nowadays that precise and absolute rules do not exist. In the present study the aim was to estimate if there are statistically significant correlations between some dimensional parameters of the temporal bone. It was stated that the smaller the distance between the sigmoid sinus and the external auditory meatus, the higher the jugular bulb is situated. Coefficient in this correlation was 0.46. However, no correlation was found between the location of the sigmoid sinus and the facial nerve on one hand and the internal carotid artery on the other. It is important for otosurgeons to know that the prominent sigmoid sinus does not determine existence of a narrow facial recess.

Adolescent↗
PubMed2001

Vestibular histopathology of the human temporal bone. What can we learn?

Histologic sections of the human temporal bone display snapshots of the entire lifetime integrated into the moment the bone enters fixative. The bulk of the literature on vestibular histopathology is anecdotal and descriptive in nature, rather than quantitative. This is because the means of describing and measuring patients' vestibular symptoms are poorly developed, and the complex geometry of the vestibular labyrinth complicates efforts to study it in serial histologic sections. Histopathologic findings in the common peripheral vestibulopathies, including Meniere's syndrome, benign paroxysmal positional vertigo, viral labyrinthitis, vestibular neuronitis, and ototoxicity, have all been described. A new quantitative method for assessment of vestibular otopathology using Nomarski optics has recently been reported. It has been successfully applied to create a normative database of age-related changes in the vestibular hair cell populations which, in turn, has been used to study the effects of aminoglycoside ototoxicity and Meniere's syndrome. These data provide the first meaningful opportunity to make structure-function correlations between vestibular function testing and temporal bone pathology in humans. Wider clinical application of vestibular function testing and postmortem temporal bone donation should be promoted by all investigators interested in accumulating the resources necessary to gain a deeper understanding of the human vestibular system in health and disease.

Aged↗
PubMed1999

[Histiocytosis X (Langerhans cell histiocytosis) of temporal bone. Role of scintigraphy in disease progress evaluation].

The authors present a case report of a 7-year-old girl with Langerhans cell histiocytosis of temporal bone. Edema and bone destruction involved zygomatic process of temporal bone and temporal fossa without ear occupation. The role of picturing diagnosis in evaluation of lesion extent with special importance of scintigraphy is discussed. Treatment methods of Langerhans cell histiocytosis lesions in temporal bone are presented. In our case locally Depo-Medrol injection was given and radiation was left as last resort management.

Child↗
PubMed2004

Temporal bone fractures: traditional classification and clinical relevance.

OBJECTIVES/HYPOTHESIS: The objectives were to evaluate the clinical relevance of traditional temporal bone radiographic descriptors and to investigate the efficacy of an alternative fracture classification scheme. STUDY DESIGN: Retrospective consecutive case series. METHODS: Charts and computed tomography scans representing 155 temporal bone fractures at a level I trauma center were reviewed. Fracture types were correlated with clinical presentation and outcomes. RESULTS: The traditional classification system (i.e., longitudinal, transverse, or mixed) correlated poorly with clinical findings such as facial nerve weakness and cerebrospinal fluid leakage. It also had limited utility in predicting conductive hearing loss and sensorineural hearing. An alternative schema distinguishing petrous from nonpetrous involvement demonstrated better correlation with these measures. Cerebrospinal fluid leak was 1.1 times more common in transverse than in longitudinal fractures but was 9.8 times more common in petrous than in nonpetrous fractures. Similarly, facial nerve injury more strongly correlated with fractures through the petrous temporal bone than did the other fracture types. Sensorineural hearing loss did not correlate with the transverse fracture classification but was significantly more prevalent in petrous fractures. Likewise, conductive hearing loss did not correlate with longitudinal fractures but was four times more common in the "middle ear" subcategory of nonpetrous fractures. CONCLUSION: Traditional temporal bone fracture descriptions correlate poorly with clinical findings. However, simply distinguishing petrous from nonpetrous involvement demonstrates significant correlation with the occurrence of serious sequelae of temporal bone fractures. Subcategories of mastoid and middle ear involvement further refine this classification schema to correlate with minor complications. This simple, radiographically based scheme better focuses clinical resources and attention toward more likely sequelae.

Adolescent↗
PubMed1996

Coccidioides immitis subperiosteal abscess of the temporal bone in a child.

A destructive granulomatous lesion of the temporal bone caused by Coccidioides immitis disseminated from a pulmonary lesion was found in a 4-year-old immunocompetent child. To our knowledge, it is the first case of coccidioidomycosis of the temporal bone reported in the world literature. The child presented with pain in her right ear and a 6-month history of intermittent fever, which partially responded to multiple courses of antibiotics. A tender erythematous postauricular swelling consistent with a subperiosteal abscess subsequently developed over 1 month. A mastoidectomy showed granulation tissue with pockets of purulence, and histologic evaluation of the specimen revealed spherules of C immitis, later verified by culture. The patient responded to intravenous amphotericin B therapy, without evidence of disease recurrence. Coccidioides immitis is endemic in regions of the Southwestern United States, with extremely infectious characteristics and relative resistance to medical therapy. Coccidioidomycosis should be considered in the differential diagnosis of a granulomatous lesion of the temporal bone.

Abscess↗
PubMed1996

Cancer of the external auditory canal and temporal bone.

Malignant tumors involving the structures of the temporal bone represent formidable diagnostic and therapeutic challenges for clinicians involved in the treatment of otologic disease. This article offers a perspective on the current understanding of the biology of malignancies involving the external auditory canal, middle ear space, and temporal bone, and reviews the often confusing and contradictory literature on this topic.

Adult↗