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PubMedDate not supplied

[Temporal bone CT in the diagnosis of acquired diseases of the external auditory canal].

CT was used to examine 50 patients (100 temporal bones) aged 10 days to 60 years who had no signs of lesion of the external auditory canal (EAC) and 23 patients (27 temporal bones) aged 13 to 65 years who had clinical manifestations of acquired stenosis or obturation of the EAC. Polypositional CT of the temporal bone is the most informative technique of visualization of the osseous part of the EAC, at the same time the anterior and posterior EAC walls were evaluated in the axial projection and the upper and lower EAC walls were assessed in the coronary projection. According to CT data, formation of the osseous part of the EAC occurs within the first 7 years of a child's life. In the presence of EAC changes, CT may assess their pattern (a soft tissue or osseous one), their magnitude and location along the walls of the canal, the tympanic membrane, and other structures of the temporal bone. CT reveals the causes of acquired EAC obturation, stenosis, and atresia: osteocartilaginous exostoses, osteomas, polyps of the EAC, tumors of the temporal bone, as well as obturative keratosis and posttraumatic stenosis of the EAC. The detected EAC changes determine further management policy in a patient.

Adolescent↗
PubMed1999

Chondroblastoma of the temporal bone: a clinicopathologic study of five cases.

Chondroblastoma is a rare benign bone tumor. It commonly affects the epiphysis of long bones during the second and third decades of life. Chondroblastoma of the temporal bone is extremely rare. We reviewed five cases of chondroblastoma arising in the temporal bone. Four cases were female and one was male. The ages ranged from 41 to 60 years (mean, 53.6 years). All cases involved the temporal bone. Three involved the left side and two the right. Chief complaints were long-standing localized pain and hearing difficulty. A sharply demarcated lobulated mass was the main radiological finding. Microscopic findings were those of chondroblastoma of usual locations. Two cases showed aneurysmal bone cyst-like areas. Immunohistochemical studies for CD34, CD99, S-100 protein and cytokeratin were performed. Tumor cells were diffusely positive for S-100 protein in three cases and weakly positive for cytokeratin in one case. CD34 and CD99 were negative in all cases. In summary, chondroblastoma of the temporal bone is rare and occurs in older age group than reported cases of chondroblastoma of the usual location in the literature.

Adult↗
PubMed2007

Optimization of ribonucleic acid detection from archival Guinea pig temporal bone specimens.

HYPOTHESIS: The choice of ribonucleic acid (RNA) isolation protocol coupled with modifications to RNA extraction and detection procedures may result in a more reliable method to detect gene expression in archived temporal bones. BACKGROUND: A large number of archival temporal bones exist. Retrospective analysis of these specimens using techniques of RNA extraction will greatly enrich our understanding of the pathophysiology of specific otologic diseases. However, archival human temporal bones are aged and embedded in paraffin or celloidin, rendering isolation and manipulation of nucleic acid in preserved specimens difficult, especially as it pertains to RNA degradation. Despite some reports of moderate success in the recent past, RNA isolation and gene expression using polymerase chain reaction (PCR) analysis continues to be challenging and unreliable. Archival guinea pig temporal bone specimens were used to develop and optimize a protocol for RNA extraction and gene expression analysis using PCR and quantitative PCR methods. The genes amplified comprise housekeeping genes and genes associated with the glutamate pathway. METHODS: Archival celloidin-embedded guinea pig temporal bones were collected from the senior author's collection of experimental hydropic inner ear specimens. RNA from this tissue was extracted using the protocol described previously in 16animals and using a modified trizol extraction technique in 10 animals. Gene expression analysis was performed on the extracted RNA. Analysis included two housekeeping genes, GAPDH and 18S, as well as three mediators of the glutamate pathway, glutamate aspartate transporter, glutamate synthetase, and inducible nitric oxide synthase. RESULTS: Compared with the standard extraction protocol, the trizol-based extraction technique showed greater reliability and reproducibility of RNA detection. The housekeeping gene GAPDH or 18S was detected in 7 of 36 attempts with the standard protocol versus 9 of 9 using the modified extraction method (P < 0.001). The gene of interest, glutamate aspartate transporter, was detected in 3 of 26 attempts with the standard protocol versus 12 of 13 attempts using the modified extraction method (P < 0.001). Quantification of messenger RNA levels was then achieved using quantitative PCR methods. CONCLUSION: Improved reliability for detection of gene expression and demonstration of reproducibility were accomplished by modification of RNA extraction technique and standard reverse transcriptase PCR protocol. In addition, we also showed that gene expression from archival material can be quantified by real-time PCR.

Animals↗
PubMed1992

Imaging of the temporal bone.

High-resolution CT remains the imaging modality of choice for investigation of the temporal bone, especially if there is suspicion of bony involvement. The advances in two- and three-dimensional reconstruction are helpful for visualizing complex osseous structures. Nevertheless, the most exciting advances regarding imaging of the temporal bone were achieved in MR imaging. Improvement of surface-coil technology, application of gadopentetate dimeglumine, and development of new imaging sequences led to an increasing importance for MR imaging, especially in inflammatory diseases. Soft tissue structures in neoplastic diseases in the temporal bone are better depicted on MR imaging. Therefore, in some cases, both modalities are used to detect soft tissue and bony abnormalities of the temporal bone, especially for cases using surgical management.

Diagnostic Imaging↗
PubMed2005

Acute mastoiditis and osteomyelitis of the temporal bone.

OBJECTIVE: Acute mastoiditis becomes clinically significant when infection spreads through the periosteum and induces periosteitis. This study describes an atypical complication of acute mastoiditis: osteomyelitis of the temporal bone. PATIENTS AND METHODS: The study sample included all patients admitted for acute mastoiditis between September 2001 and December 2003 who had symptoms, signs and imaging findings of osteomyelitis of the temporal bone beyond the mastoid area. The files were reviewed for diagnosis, work-up, radiographic findings and treatment. RESULTS: The study group included 6 of the 120 patients treated for acute mastoiditis. In four children (66%), the diagnoses of acute otitis media and acute mastoiditis were made simultaneously at admission. Ear cultures yielded coagulase-positive Staphylococcus in three patients, Bacteroides in two, multiple organisms in two, S. pneumoniae in one, and no growth in two. Complications were suspected if there was a lack of improvement in symptoms and signs, or in cases of skin involvement over the temporal bone beyond the area of the mastoid in accordance with imaging findings. Computerized tomography demonstrated temporal bone absorption beyond the mastoid area (squama and/or petrous bones) in all children, suspected sinus vein thrombosis in two, and suspected epidural abscess in one. All children were treated with at least cortical mastoidectomy and insertion of ventilation tubes. Revision mastoidectomy was performed in three children in whom no improvement was noted and imaging suggested other complications. CONCLUSION: The present study describes an unusual complication of acute mastoiditis-osteomyelitis of the temporal bone beyond the mastoid framework. The disorder is characterized by a failure to respond both locally and systemically to accepted medical and surgical therapy, persistent fever and high levels of inflammatory markers, and computerized tomography findings of temporal bone destruction. Treatment includes broad-spectrum antibiotics and at least cortical mastoidectomy. Prognosis is good.

Acute Disease↗
PubMed1990

Temporal bone findings in two cases of head injury.

Temporal bone findings in two cases of head injury are reported. In one patient, longitudinal fractures occurred in both temporal bones, and extended to the middle ear bilaterally. Bleeding was seen in the tympanic cavity, mastoid air cells, internal auditory meatus and facial nerve canal. Bleeding was observed in the scala tympani, cochlear aqueduct and endolymphatic sac, but there were no fractures. In the other patient, bleeding was seen in the internal auditory meatus and facial nerve canal. In the right ear, endolymphatic hydrops was observed in all turns of the cochlea.

Adult↗
PubMed2004

Chondrosarcomas of the temporal bone: presentation and management.

Chondrosarcomas (CSA) of the temporal bone are rare primary malignant tumours that are slow growing, but locally aggressive. The management of CSAs involving the temporal bone is challenging and necessitates a multidisciplinary approach in a tertiary referral unit well practised in skull base surgery. Their management with particular reference to modes of presentation and treatment strategies has been reviewed here.

Chondrosarcoma↗
PubMed1997

Intracranial complications of temporal bone osteoradionecrosis.

OBJECTIVE: To present four cases of life-threatening intracranial complications associated with temporal bone osteoradionecrosis. STUDY DESIGN: This study was a retrospective case review of four patients combined with a literature review. SETTING: All patients were treated at Loyola University Medical Center, which is a tertiary care facility. PATIENTS: The four patients were retrospectively reviewed without demographic constraints. INTERVENTIONS: All patients underwent preoperative radiographic assessment (magnetic resonance imaging/computed tomography scan), and three of the four patients underwent surgery. MAIN OUTCOME MEASURE: The role of surgical intervention in the management of advanced temporal bone osteoradionecrosis. RESULTS: Three patients underwent mastoid surgery after medical treatment of intracranial complications associated with temporal bone osteoradionecrosis. All three patients had dry, epithelialized mastoid cavities. One patient died as a result of meningitis. CONCLUSIONS: Mastoid surgery should be used in the overall management of patients with advanced temporal bone osteoradionecrosis to prevent secondary intracranial complications.

Adult↗
PubMed2003

A histologic study on the temporal bone of guinea pigs.

OBJECTIVES: We examined histopathologic and anatomical features of the guinea pig temporal bone and evaluated the differences and similarities with respect to the human ear. STUDY DESIGN: Seventeen adult guinea pigs were deeply anesthetized with pentobarbital and then decapitated. Each temporal bone was removed and fixed in 10% formaldehyde for a week, then decalcified in 10% formic acid for three weeks. Paraffin-embedded specimens were serially and horizontally sectioned at 7-micron thickness. One of every five sections was stained with hematoxylin and eosin and studied under light microscopy. RESULTS: The temporal bone consisted of a mastoid-like process, a tympanic bulla, a tympanic ring, a petrosal segment, and a poorly developed squamosal bone. The tympanic bulla was a semispherical cavity surrounded by the tympanic ring. The head of the malleus and the body of the incus were fused, forming a malleoincudal complex. The diameters of the tympanic sulcus and the tympanic membrane were much greater than that of the tympanic ring, resulting in protrusion of the external ear-canal into the bulla. The Eustachian tube was J-shaped, lying in a bony hiatus at the anteromedial aspect of the bulla. The inner ear consisted of the cochlea, semicircular canals, and the vestibule. The cochlea made 3.5 turns and projected into the bulla. No internal auditory meatus was observed. CONCLUSION: The guinea pig temporal bone was found to have histological similarities to that of humans, making it a good model for selected experimental studies in otology.

Animals↗
PubMed1994

High resolution computed tomography of the temporal bone: preliminary experience.

High Resolution Computed Tomography (HRCT) can demonstrate the detailed anatomy and pathology of the temporal bone and is fast becoming an important imaging modality in the diagnosis and preoperative management of our local patients with temporal bone diseases. We present our experience in the usage of HRCT in temporal bone lesions in Tan Tock Seng Hospital, using 8 cases as illustration. The protocol that we used to obtain the images is described. We also give an overview of those clinical conditions whereby HRCT can provide information which will help surgeons in the management of their patients. These clinical conditions are hearing loss, external auditory canal atresia, middle ear inflammation/cholesteatoma, temporal bone trauma, pulsatile tinnitus and vascular tympanic membrane.

Adult↗
PubMed2006

Cochlear implantation in the irradiated temporal bone.

OBJECTIVE: To demonstrate the feasibility and complexities of cochlear implantation in the setting of bilateral temporal bone osteoradionecrosis. STUDY DESIGN: Case report. SETTING: Tertiary care referral centre. CASE DESCRIPTION: A 66-year-old woman with bilateral temporal bone osteoradionecrosis and profound hearing loss, following treatment for tonsillar cancer, underwent cochlear implantation. Prior canal wall down mastoidectomy and subsequent temporal bone resection with free flap reconstruction had been performed on the implanted ear. The contralateral ear received a canal wall down mastoidectomy. A completely dehiscent mastoid segment of the facial nerve and extensive fibrosis were evident in the implanted ear. Only minimal fibrous reaction was found within the cochlea, allowing for full electrode insertion. At three months, speech recognition testing documented a consonant-nucleus-consonant (CNC) word score of 54 per cent. CONCLUSIONS: This report demonstrates the feasibility of cochlear implantation after temporal bone surgery and free flap reconstruction in the setting of diffuse osteoradionecrosis. The patient's excellent open-set speech understanding using the cochlear implant implies that radiation did not severely damage the central auditory pathways. Thus, some patients with radiation-induced hearing loss may be appropriate cochlear implant candidates. Special attention should be paid to surgical planning, as complications related to wound healing, electrode insertion and facial nerve injury may be more likely.

Aged↗
PubMed2006

Three-dimensional virtual model of the human temporal bone: a stand-alone, downloadable teaching tool.

OBJECTIVE: To develop a three-dimensional virtual model of a human temporal bone based on serial histologic sections. BACKGROUND: The three-dimensional anatomy of the human temporal bone is complex, and learning it is a challenge for students in basic science and in clinical medicine. METHODS: Every fifth histologic section from a normal 14-year-old male was digitized and imported into a general purpose three-dimensional rendering and analysis software package called Amira (version 3.1). The sections were aligned, and anatomic structures of interest were segmented. RESULTS: The three-dimensional model is a surface rendering of these structures of interest, which currently includes the bone and air spaces of the temporal bone; the perilymph and endolymph spaces; the sensory epithelia of the cochlear and vestibular labyrinths; the ossicles and tympanic membrane; the middle ear muscles; the carotid artery; and the cochlear, vestibular, and facial nerves. For each structure, the surface transparency can be individually controlled, thereby revealing the three-dimensional relations between surface landmarks and underlying structures. The three-dimensional surface model can also be "sliced open" at any section and the appropriate raw histologic image superimposed on the cleavage plane. The image stack can also be resectioned in any arbitrary plane. CONCLUSION: This model is a powerful teaching tool for learning the complex anatomy of the human temporal bone and for relating the two-dimensional morphology seen in a histologic section to the three-dimensional anatomy. The model can be downloaded from the Eaton-Peabody Laboratory web site, packaged within a cross-platform freeware three-dimensional viewer, which allows full rotation and transparency control.

Adolescent↗
PubMed1990

Glomus bodies in the temporal bone.

There are very few studies in the literature of the anatomy of glomus bodies in the temporal bone, and their function in the normal ear remains undiscovered. In this study, human, squirrel monkey, and cat temporal bone sections were examined by light microscopy for the presence of glomus bodies, and the anatomy and distribution of glomus bodies in the temporal bone is described. For the first time, glomus bodies have been identified in non-human temporal bone sections. A possible function for these chemoreceptor-like structures in the ear is discussed.

Adolescent↗
PubMed1982

[Giant cell tumor of the temporal bone--case report (author's transl)].

The majority of giant cell tumors occurs in the long bones, especially around the knee, and only 1.4-1.8% of cases are found in the skull. In this communication, a case of giant cell tumor of the temporal bone is reported because of a rarity of the lesion in the skull. The 37-year-old housewife was admitted to our clinic complaining of swelling in right temporal region which had gradually developed over a two-month period. On examination, there was a swelling about 5cm in diameter beneath right temporal muscle; its surface was smooth and its consistency was hard. Tenderness was found in its center. Routine x-ray of the skull showed osteolytic lesion in right temporal bone with relatively clear margins. Computed tomography demonstrated heterogeneously high-density mass in right temporal bone and right middle fossa. The tumor located mainly within the temporal bone at the middle fossa, and intracranial epidural space at the convexity. After bolus injection of contrast material, the tumor of temporal bone and the peripheral portion of the intracranial tumor were enhanced markedly. Right external carotid angiograms disclosed tumor stain in capillary and venous phases. Abnormal RI uptake was disclosed by bone scintigrams with 99mTC-methylene diphosphonic acid. Her preoperative diagnosis was calvarial tumor with intracranial extension. A right fronto-temporal osteoplastic craniotomy was performed. The tumor located within the temporal bone and in epidural space which invaded temporal muscle and underlying dura. The tumor was elastic soft and vascular with central necrosis. The tumor was extirpated totally including surrounding temporal muscle and dura. Microscopic examination of the operative specimen revealed giant cell tumor of the skull. Therefore, she was treated with 60CO irradiation (3,000 rads) to the temporal region. In the 13 months since the completion of treatment, there has been no sign of recurrence nor metastasis. Giant cell tumor of the skull were reviewed with special references to diagnosis and treatment. Computed tomographic findings of this tumor were also discussed briefly.

Adult↗
PubMed1981

Giant cell lesions of the temporal bone.

Giant cell lesions are rare in the temporal bone. A review of world literature reveals twenty-three reported cases. Histopathologic differentiation has been difficult in the past; several tumors of bone which are characterized by multinucleated giant cells have been grouped together under the term "giant cell tumor." In the temporal bone, true giant cell tumor of bone, osteoclastoma, should be differentiated from the less aggressive reparative granuloma. The clinical course of these two lesions can be greatly different. Two additional cases of giant cell reparative granuloma are added to the literature. In addition, a tabulation is presented of signs, symptoms, treatment, and follow-up in the cases reported in the literature. Surgical excision is recommended when possible.

Adult↗
PubMed2000

Invasive verrucous carcinoma: a temporal bone histopathology report.

Only nine cases of primary verrucous carcinoma of the temporal bone have been reported in the English literature. We describe histopathologic findings in a 78-year-old man dying of intracranial complications of primary verrucous carcinoma of the external auditory canal. Following autopsy the temporal bone was prepared for light microscopic examination. The temporal bone was serially sectioned horizontally after fixation, decalcification, and embedding, and each 10th section was stained with hematoxylin and eosin and examined by light microscopy. The carcinoma originated from the external auditory canal, infiltrating the mastoid cavity, the middle ear, tissue adjacent to the internal carotid artery, and the posterior cranial fossa, where it invaded the right cerebellum and produced an abscess. The labyrinth and internal auditory canal were not infiltrated. Metastasis to lymph nodes or distant sites was not identified. In the present case, the verrucous carcinoma originating from the external auditory canal extended into the posterior cranial fossa, while it did not invade the membranous labyrinth.

Aged↗
PubMed1997

[Morphological characterization and classification of air cells in temporal bone by digital processing of CT images].

We determined the extent of pneumatization in the temporal bone and reconstructed three-dimensional structures of air cells by computer-assisted digital processing of high resolution CT images of the bone. We attempted morphological classification of temporal bone air cells by characterization of the three-dimensional structures obtained. A total of 52 ears in 33 normal subjects (18 males and 15 females; mean age 51 years) was examined. The volume of pneumatization in the temporal bone, as measured by CT, ranged from 2.08 to 20.05 ml (mean 6.40 +/- 4.09). The morphological characteristics of air cells in the three-dimensional images were examined with reference to the volume of air cells and the direct on of their growth. The three-dimensional structures were observed from four directions (lateral, supralateral, anterolateral and supramedial). Large air cells existed plentifully in all directions. Anteriorly, air cells were growing in two directions; laterally and toward the petrous apex. The growth in the latter direction was especially marked, and this contributed to the growth in the medial direction. Air cells that grew anteriorly had two directions of growth (lateral and toward the petrous apex). The directional difference in growth varied with the ear. On examining the suprainferior growth, air cells that grew large in the anterior direction were found to grow large in the suprainferior direction and those that did not grow large in the anterior direction were found contrarily to grow poorly in the suprainferior direction. With the above morphological characteristics taken into consideration, morphological classification of air cells into five types was attempted by the volume of air cells and the direction of their growth.

Adolescent↗
PubMed1991

Evaluation of results of temporal bone resection.

The results of 16 cases of temporal bone resection were evaluated. The resections, 12 of which were total and 4 partial, had mostly been performed for squamous cell carcinoma invading the temporal bone. Five patients in whom the intervention was considered radical and not followed by irradiation, were alive and well 9 years or more later. The significance of postoperative radiotherapy was demonstrated in 3 patients who were alive and in good health 9 years or more later, although histological examination of resection margins showed residual tumour. Eight patients died 10 months to 5 1/3 years after operation, 6 of whom from recurrence, one from radiation necrosis of the temporal lobe of the brain, and one from cerebrovascular occlusion. Histologically, squamous cell carcinoma was found significantly more among the patients who died from recurrence than among those still living.

Adult↗