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PubMed1980

Temporal bone studies in anencephaly.

The principal anatomical and histological features of the temporal bones of three anencephalics are described, one a twin-headed monster, with four temporal bones. These may be summarized as follows: Malformation of ossicles. Mondini type malformation of the cochlea. Occasionally cochlear hydrops or collapse of Reissner's membrane, following apparently on its rupture. Distension of the vestibular labyrinth and oedema of the perilymphatic spaces and membranes. Rupture of the saccular wall with 'sealing off' and repair of the tears and gaps by coagulated lymph material. Fibrous obliteration of the internal auditory meatus containing scanty nerves and neurones. Geniculate ganglion and facial nerve present and appear to be normally developed. The neuro-epithelial structures were well developed despite the total or partial absence of the central nervous system. The temporal bones of anencephalics offer an excellent source of comparative anatomy for the study of the pathology of Menière's disease and sensorineural lesions.

Anencephaly↗
PubMed1993

Temporal bone histopathology 14 years after cytomegalic inclusion disease: a case study.

Temporal bones were examined from a 14-year-old male who died of sequelae of congenital cytomegalic inclusion disease (CID). Cytomegalovirus (CMV) was not isolated from inner ear fluid or multiple systemic tissues at the time of death. Examination of temporal bones revealed chronic pathology of both cochlear and vestibular sensory and nonsensory tissues. Endolymphatic hydrops was observed in the basal turn of the cochlear duct, while Reissner's membrane was collapsed in the more apical turns. Strial atrophy and a loss of cochlear hair cells were observed along the entire length of the basilar membrane. Vestibular neuroepithelial regions were degenerated and fibrosis was seen within the vestibular perilymphatic tissue spaces, suggesting prior labyrinthitis within the perilymph compartment in addition to the more typical pattern of endolabyrinthitis associated with human CMV infection. Distention of the saccular membrane was evident. In both cochlear and vestibular tissues, there were isolated regions of calcifications that appeared characteristic to that reported in other organ systems of individuals with CID. Collectively, these chronic, pathological findings in this case of CID demonstrate more extensive injury than has been identified in the previously reported acute temporal bone pathology of CID.

Cochlea↗
PubMed1990

High resolution computed tomography of the temporal bone in infants and children: a review.

Pathologic conditions involving the temporal bone in infants and children are now commonly diagnosed by computed tomography (CT). The importance of utilizing high resolution computed tomography (HRCT) with magnified, thin (1.5 mm) scans in both the axial and coronal planes is stressed in order to obtain the maximal anatomic information that is critical for proper diagnosis. A retrospective analysis of 388 cases reveals a positive diagnostic yield ranging from 65% in temporal bone trauma to 20% in clinically suspected neoplasm. Selected case reports of congenital abnormalities, inflammatory processes, traumatic lesions, and tumors will be presented. We conclude that HRCT is an excellent diagnostic modality and should be used liberally to evaluate the temporal bone in children.

Adolescent↗
PubMed2006

[Ossifying fibroma of the temporal bone].

OBJECTIVE: To describe the clinical presentation of ossifying fibroma of the temporal bone, and to discuss its diagnosis and treatment. METHOD: A rare case of ossifying fibroma of the temporal bone was presented. The patient was a 8-year-old boy with a one year history of left ear discomfort, suppurative otorrhea and progressive hearing loss. Physical examination of the ear revealed a stenosis of left external auditory canal (EAC), and an obvious expansion at mastoid region. Audiometry showed no hearing of the left ear. A postauricular approach was used to expose the mass. Frozen section evaluation during operation was not definitive but suggested benign nature in histology. The tumor was fully resected. The EAC was sealed by sutured skin, and the extended mastoid cavity was obliterated with abdominal fat. RESULT: The final pathological report indicated the stromal cells were negative for S-100 protein and epithelia membrane antigen (EMA), supporting the diagnosis of ossifying fibroma. One-year follow-up showed the sealed EAC was satisfactory with complete interior and no tumor recurred. CONCLUSION: Ossifying fibroma of the temporal bone is a rare entity, which is a benign neoplasm but may show an aggressive behavior by compression and encroachment upon adjacent structures. Early and complete removal was advocated.

Bone Neoplasms↗
PubMed2005

Temporal bone encephaloceles.

PURPOSE OF REVIEW: This paper reviews the latest literature relating to the diagnosis and treatment of temporal bone encephaloceles, defined as the herniation of meninges or brain tissue into areas of the temporal bone, for example, the petrous apex, tegmen tympani or mastoid cavity. RECENT DEVELOPMENTS: The diagnosis of temporal bone encephaloceles can be challenging. The condition is commonly presented as cerebrospinal fluid otorrhea or rhinorrhea in addition to a variety of symptoms such as conductive hearing loss. Imaging is also important in the diagnosis stage. Management of the condition is surgical, and this review outlines the surgical options. SUMMARY: Encephaloceles of the temporal bone are encountered rarely in otologic medicine. Given the possibility of cerebrospinal fluid leaks and meningitis, however, the otolaryngologist or otologist must have a working knowledge of the correct diagnostics and treatments.

Encephalocele↗
PubMed1994

The ear in the acquired immunodeficiency syndrome: I. Temporal bone histopathologic study.

A postmortem histopathologic investigation of temporal bones of patients with the acquired immunodeficiency syndrome (AIDS) was performed after microslicing, acid decalcification of the slices and paraffin embedding. Histopathologic changes in 49 temporal bones from 25 patients included severe otitis media in five patients (20%), low-grade otitis media in fifteen (60%), labyrinthine cryptococcosis in two, Kaposi's sarcoma deposit in the eighth nerve of one, and cytomegalovirus (CMV) inclusion-bearing cells in the inner and middle ear of six (24%). It was possible to identify the CMV genome by in situ hybridization in only two bones and expression of CMV antigen by immunohistochemistry in none, probably because of prolonged decalcification in acid. The ear is no less susceptible to AIDS-associated diseases than any other organ, and is particularly prone to CMV infection.

AIDS-Related Opportunistic Infections↗
PubMed1979

[Surgical treatment of early facial palsies in cases of longitudinal fractures of the temporal bone (author's transl)].

Longitudinal fractures of the temporal bone are complicated by facial palsies in 10--25% According to the results of Fisch the lesions of the facial nerve are ever situated at the labyrinthine segment of the nerve. The most frequent lesion is the impression of bone fragments in the Fallopian canal. Clinical controls of the progredience of the palsy and tomographies are necessary. The only successful therapy in cases of early facial palsies due to longitudinal temporal bone fractures is the total decompression of the facial nerve with the combinated transmastoid approach and middle fossa approach.

Facial Paralysis↗
PubMed1987

Correlation of high-resolution computed tomography and gross anatomic sections of the temporal bone: Part I. The facial nerve.

Detailed anatomic analysis of the human temporal bone has been made possible by correlating high-resolution computed tomography (CT) with gross anatomic sections. Serial CT scans of isolated temporal bones were obtained in the transaxial (horizontal), coronal, and sagittal planes at 1.5-mm intervals. The temporal bone was sectioned at 2.0-mm intervals in planes parallel to the CT scans. Based on a correlation of these sections, the facial nerve canal was divided into four segments and the planes in which each is best observed are described and illustrated. The first segment in the internal auditory canal is best visualized in the sagittal plane, the labyrinthine segment and geniculate ganglion in the coronal and transaxial planes, the tympanic portion in the sagittal plane, the genu, between the tympanic and mastoid portion, in the sagittal plane, and the mastoid portion and the stylomastoid foramen in the coronal and sagittal planes.

Facial Nerve↗
PubMed1993

Immunohistochemical study of intermediate filament proteins on routinely processed, celloidin-embedded human temporal bone sections by using a new technique for antigen retrieval.

Although immunohistochemical studies of intermediate filament proteins have been carried out on temporal bone sections by using modified fixation/embedding techniques to preserve antigenicity, there have been no light microscopic studies concerning immunohistochemical staining on routinely formalin-fixed celloidin-embedded human temporal bone sections. A method for immunostaining routinely processed celloidin-embedded tissues would be extremely valuable in that it would permit study of the extensive collections of formalin-celloidin temporal bone specimens that exist in major centers of otopathologic research. Recently, we have developed a new technique which can be used to retrieve the antigenicity masked by formalin fixation and decalcification. This method requires immersing slides for 30 min at room temperature in a solution of saturated sodium hydroxide in methanol before immunostaining. Using this method, 45 celloidin-embedded human temporal bone sections were stained with monoclonal antibodies to keratin, vimentin, neurofilament, glial fibrillary acidic protein and desmin as primary antibodies using a sensitive streptavidin-biotin procedure. The results obtained by using this technique are at least equivalent to those obtained with modified fixatives, cryosections or immuno-electron microscopy. This new method may provide a useful approach for studying routinely processed, celloidin-embedded human temporal bone sections and open a new field in immuno-otopathology.

Adult↗
PubMed1988

[Radiodiagnosis of temporal bone anomalies].

The X-ray findings in temporal bone anomalies are reviewed. Radiological procedure and examination technique are presented, as are symptoms of important anomalies. The methods available are plain film X-ray of temporal bone, multi-directional tomography, and high-resolution CT. Although some of the abnormalities are visible even in plain films, consistent use of conventional tomography or CT is necessary for correct diagnosis. This procedure is indicated not only when an abnormality is clinically obvious, but also in all cases of unexplained hearing loss without evidence of acquired disease. The advantage of CT over conventional tomography is that soft tissue anomalies, such as primary cholesteatoma or tumor simulating vascular abnormalities, can be demonstrated. In these cases CT is obligatory.

Cochlea↗
PubMed1994

[Comparison of CT and MRI methods in diagnosis of tumors of the para- and retropharyngeal space and temporal bone].

The aim of this paper was to compare the diagnostic value of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of malignant tumors of the temporal bone, of paragangliomas of the glomus tympanicum and jugulare as well as of malignant tumors of the para- and retropharyngeal space. 67 patients with tumors of the temporal bone--28 cases with malignant tumors and 39 cases with paragangliomas--were examined with MRI and CT. MRI had true-positive findings in nearly 93, CT in 89% of the patients with malignant tumors of the temporal bone. MRI is therefore recommended as the primary imaging investigation of malignant tumors of the temporal bone. Whereas the temporal bone is best visualized by high-resolution CT with thin slices, the tumor extension--especially cranial spread into the middle and posterior cranial fossa and caudal spread into the infratemporal fossa--is better detected on MRI. Enhanced T1-weighted spin-echo images with fat-signal suppression are most suitable for this purpose. Using 3D sequences, partial volume effects can be avoided with an attainable slice thickness of 0.8-1.0 mm. Furthermore, arbitrary slices--very helpful when studying the complex anatomy of the skull base--can be calculated from a 3D data set. MRI had true-positive findings in 97, CT in nearly 90% of the patients with paragangliomas. Furthermore, the response of paragangliomas to radiotherapy can be more accurately assessed on MR--independent of and before volumetric changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Contrast Media↗
PubMed1998

The temporal bone. Contemporary diagnostic dilemmas.

The entire topic of temporal bone imaging cannot be addressed in a single article. This article discusses the clinical areas in which there have been particularly important advances: inflammatory disease, sensorineural hearing deficit, pulsatile tinnitus, facial nerve dysfunction, and the postoperative temporal bone. The common thread linking those sections is an attempt to emphasize their pitfalls.

Bone Diseases↗
PubMed1991

Management of temporal bone carcinomas: a therapeutic analysis of two groups of patients and long-term followup.

Fifty-one patients with squamous cell carcinomas arising within the temporal bone were subdivided into two groups. The initial group of 17 patients, seen between 1960 and 1980, were reviewed retrospectively and staged into four subgroups on the basis of initial tumor presentation and location (i.e., external auditory canal, superficial invasion, deep invasion, and tumors beyond the temporal bone). After treatment in a variety of surgical and radiotherapeutic combinations, the 5-year cure rates were: 70%, 70%, 50%, and 9%, respectively. Thirty-four patients, seen between 1980 and 1989, were placed in a new prospective protocol for combined surgery and postoperative irradiation. These patients were subdivided into the same subgroups on the basis of tumor location. The surgical procedures were formalized to be more encompassing (i.e., external canal tumors were treated by sleeve resection of the internal auditory canal and tympanic membrane, superficial invasion by superficial temporal bone resection, deep tumors by radical temporal bone resection, and those beyond the temporal bone by an infratemporal fossa approach). Radical neck dissections were performed where needed. The irradiation dosage was increased to 6250+ cGy, with a 4:1 ratio in favor of electrons for deeper penetration, and the fields were widened. At 36.6-month average followup, the cure rates were: 100%, 100%, 70%, and 65%, respectively. Six of ten patients with neck metastases at presentation had tumor recurrence or distant disease (60%).

Adult↗
PubMed1986

Magnetic resonance imaging of temporal bone and cerebellopontine angle lesions.

Lesions of the temporal bone and cerebellopontine angle present a diagnostic challenge because of the complex anatomy, multiplicity of lesions, and difficulty in imaging the dense bone of this area. Magnetic resonance imaging, a new, nonionizing imaging modality, dependent on monitoring a radiofrequency signal emitted by excited nuclei in an external magnetic field, has shown promise in imaging of the temporal bone and posterior fossa.

Adult↗
PubMedDate not supplied

The caloric stimulus. Temperature generation within the temporal bone.

Temperature measurements were performed on isolated cadaveric temporal bones subjected to caloric irrigation of the external meatus. This was undertaken in an attempt to clarify the pathways of heat transfer involved in thermal stimulation of the temporal bone. On average, the maximum temperature change produced across the lateral semicircular canal was 0.47 degrees C, occurring 74 s after the start of the 30-s irrigation. Temperature changes of approximately 1.5 degrees C were found to occur in the air of the middle ear cleft, indicating significant heat transfer by the process of natural convection. By comparison, removal of the bony ridge joining the external meatus with the inner ear had little effect on the temperature generated across the lateral semicircular canal. It is therefore considered that natural convection within the middle ear cleft plays an important role in caloric stimulation of the vestibular labyrinth. This view is supported by the observation that there is a lack of a direct solid connection between the outer ear and lateral limb of the lateral semicircular canal.

Body Temperature Regulation↗
PubMedDate not supplied

Temporal bone findings in a patient with Möbius syndrome.

Temporal bone findings in a case of Möbius syndrome are presented. The most striking pathological feature of the case is that the facial nerves ended in the horizontal segment in the temporal bones on both sides. This finding gives direct evidence that the site of nerve lesion in Möbius syndrome is in the peripheral nerve. Despite the disappearance of facial nerve in the horizontal segment, a neural element reappeared in the vertical segment of the fallopian canal, and moreover, the chorda tympani was found to cross the tympanic cavity in the normal position. This finding suggests that fibers of the chorda tympani sometimes take an alternative pathway via Arnold's nerve.

Aged↗
PubMed1980

Thin section computed tomography of the temporal bone.

The applications of computed tomography (CT) in temporal bone studies have increased because of thin sections (less than 2 mm), high spatial resolution (less than 0.8 mm) and high resolution reconstruction algorithms. Thin section CT was performed in 56 patients suspected of having acoustic neuromas, other tumors, cholesteatomas or fractures. High resolution experimental image reconstruction was performed in some cases. In most cases, the pathologic process was demonstrated as well or better on CT scans than on complex motion tomograms. We concluded that high resolution, thin section CT is the technique of choice to evaluate patients with temporal bone tumors. CT is an effective means of studying patients with large cholesteatomas and fractures, although conventional tomography may be complementary in some cases. The value of CT in patients with otosclerosis and inflammatory disease of the middle ear should be evaluated more extensively.

Adult↗
PubMed1980

Fibrous dysplasia and the temporal bone.

The cause of fibrous dysplasia of the bone is obscure. We reviewed the available literature concerning temporal bone involvement and analyzed temporal bone involvement and analyzed the most common aspects of this fascinating disease, adding three cases of our own. A clinical staging is proposed: stage 1, latent; stage 2, symptomatic; and stage 3, complication. Clinical evolution and follow-up are described and treatment is suggested.

Adult↗