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At least 433 records · Page 24Linked to original sources
PubMed2002

Minimal distances between temporal bone structures and their mutual correlations.

BACKGROUND: The minimal distances between basic temporal bone structures limit the operating field in ear surgery. The aim of the present study was to perform measurements on the minimal distances between key structures of the temporal bone and to investigate possible correlations between given structures. MATERIAL/METHODS: The author removed 100 temporal bones from subjects of both sexes, across a range of age groups and from both sides of the body. Minimal distances were measured between the following structures: the lateral semicircular canal (SC), the tympanic ring (TR), the hard meninges of the middle cranial fossa (HM), the facial nerve (FN), the upper bulb of the internal jugular vein (JB) and the internal carotid artery (CA), collected in the appropriate pairs. The samples were measured using an operating microscope equipped with a graduated eyepiece. RESULTS: The results are presented in various categories according to age, sex, and side of the body. Five pairs of distances were found to be significantly shorter in younger children (group I) than in older children and adults (group II). CONCLUSIONS: Ear surgery in younger children demands much more care than in older children and adults, especially regarding situations when the jugular bulb is in the operating field.

Adolescent↗
PubMed1988

Surgical management of osteoradionecrosis of the temporal bone.

The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.

Child↗
PubMed2005

Primary temporal bone angiosarcoma: a case report.

We present a rare case of temporal bone angiosarcoma diagnosed in a 26-year-old female patient at 36 week of pregnancy. The patient was referred with a 2 months history of left otalgia and tinnitus with a tender swelling above the mastoid. Cranial imaging studies showed a 7 x 5 x 4 cm hypervascularized mass located in the left middle fossa with lysis of the temporal bone and extension to the subcutis. After the baby was delivered by caesarean section, the patient entered the oncology protocol. Selective embolization of the feeding vessels was followed by gross total surgical resection using a combined supra- and infra-tentorial approach. Pathological findings were those of a poorly differentiated, highly malignant sarcoma with a large epitheloid component and immunohistochemical evidence of endothelial differentiation (CD31, Factor VIII related antigen, CD34), consistent with an angiosarcoma with epitheloid features. No extra-cranial tumor was found after extensive staging. The patient received adjuvant radiotherapy followed by a course of chemotherapy consisting of 6 cycles of paclitaxel. At 15 months follow-up, she developed multiple distant metastasis to a left postauricular lymph node and to the lungs and ribs. The patient was given a second line chemotherapy using doxorubicine and ifosfamide. Despite an initial good response, she died with metastatic disease 26 months after diagnosis. We present a rare case of primary temporal bone angiosarcoma and report our experience with a multimode therapeutic approach combining surgery, radiotherapy and chemotherapy.

Adult↗
PubMed2001

Aplasia of the cochlear nerve: a temporal bone study.

OBJECTIVE: The purpose of this study was to evaluate the temporal bone findings in individuals with cochlear nerve aplasia. STUDY DESIGN: Retrospective case review. METHODS: Two individuals with unilateral profound deafness caused by aplasia of the cochlear nerve were identified. The temporal bones were processed, and the cochlear elements were quantified. RESULTS: Histopathologic study of the temporal bones from these individuals demonstrate that a fully formed cochlea and normal-appearing organ of Corti can occur in the absence of the spiral ganglion and cochlear nerve. Cochlear nerve aplasia can occur in both a narrow or a normal-sized internal auditory canal. CONCLUSION: These findings suggest that the development of the cochlea and organ of Corti are not dependent on the presence of the cochlear nerve and spiral ganglion. The entity of cochlear nerve aplasia in the presence of a normally formed cochlea must be considered when evaluating individuals as candidates for cochlear implantation.

Adult↗
PubMed1994

Temporal bone fibrous dysplasia and cholesteatoma leading to the development of a parapharyngeal abscess.

Monostotic fibrous dysplasia of the temporal bone is a rare disease entity that may lead to progressive stenosis of the external auditory canal with resultant trapping of skin and the development of cholesteatoma. The cholesteatoma may extend widely into the temporal bone. Once cholesteatoma occupies the petrous apex, erosion out of the temporal bone can occur superiorly into the middle fossa, posteriorly into the posterior fossa, inferiorly into the neck, and infero-medially into the parapharyngeal space. We present a case in which minimal symptoms were present despite a massive temporal bone fibrous dysplasia and cholesteatoma. Eventually, cholesteatoma eroded into the parapharyngeal space, leading to airway compromise. Late presentation occurred because the otic capsule was spared, there was no external skull deformity and there was slow inferior and medial growth that was well tolerated, until the development of a parapharyngeal space abscess.

Abscess↗
PubMed1977

Impact trauma of the human temporal bone.

A cooperative study between the Department of Otorhinolaryngology and the Highway Safety Research institute of the University of Michigan was designed to study temporal bone fracture produced in cadavers subjected to realistic automotive impact situations. Utilizing sled and piston impact configurations frontal and parietal impacts were noted to produce ipsilateral and contralateral fractures of nine temporal bones in seven cadavers. The impact velocities varied between 18.1 and 25.0 mph. Using standard otologic microsurgical techniques, the temporal bones were dissected and numerous gross and microscopic injuries to middle and inner ear structures were found. The authors conclude that extensive comminuted fracture of the human temporal bone is seen with realistic crash situations of low velocity, and that lateral impact which produces a longitudinal fracture with a posterior fossa comminution is associated with disruption of the cochlea and facial nerve, as well as of middle ear structures. The classical transverse fracture of extensive skull trauma lies medial to these structures and does not involve the otologic contents of the human temporal bone. Associated brain and skull injuries are also described.

Accidents, Traffic↗
PubMed1997

Preoperative assessment of the implantable middle ear pump system using CT scans and conventional X-rays of the temporal bone.

A completely implantable micropump system for drug delivery has recently been developed. After implantation in the temporal bone, this microdosage system enables application of drugs into the middle ear and round window area. Successful application of this new technology depends upon a suitable fit of the micropump within the patient's temporal bone. To obtain information about the fit before surgery, we analyzed 50 cadaver temporal bone specimens before total mastoidectomy, using conventional X-ray and spiral CT scans for water volume determination. Spiral CT is a feasible method for preoperative planning of the surgical implantation of the implantable middle ear micropump system (TI-DDS). The best parameter for a preoperative judgment is the volume of the mastoid cavity, as determined by CT. Implantation may be recommended when the mastoid volume, as measured by CT, is greater than 6.6 ml. To be certain that the implantable drug delivery system will be implantable, a cut-off value of 9.3 ml seems to be advisable. Spiral CT imaging is of great value as a tool for testing implantation preoperatively. The imaging is accomplished in approximately 30 seconds. Our preliminary results with cadaveric temporal bones are encouraging. Further studies are needed in order to transfer the results to a clinical implantation situation.

Ear, Middle↗
PubMed2002

Adenoid cystic carcinoma of the temporal bone with distant metastases.

Malignant tumors of the temporal bone are rare neoplasms. Adenoid cystic carcinoma (ACC) is the most common malignant tumor of minor salivary glands, while a quite rare tumor of the major. It is considered a slow-growing tumor with a course that is characterized by local recurrences and late distant metastases to lungs (80-90%), bone and liver. When metastases occur in bone especially the spine, the course of disease is usually fulminant. Intracranial involvement can occur by direct extension, hematogenous or perineural spread and represents an advanced stage of the disease. In this paper, we present a rare case of temporal bone ACC reporting for the first time simultaneous bony and pulmonary distant metastases. The origin, the pathology, the imaging techniques, the differential diagnosis, the treatment options and the prognosis of these tumors are discussed.

Aged↗
PubMed2006

Preliminary study on digitized nasal and temporal bone anatomy.

The purpose of this study was to explore a feasible method for the reconstruction of the nasal and temporal bone structures of the Chinese virtual human project and provide a more accurate and facilitated way view them three-dimensionally (3D). The 3-D Slicer software was used to reconstruct the anatomic structures of the human nose and temporal bone. Segmentation and extraction of the contours of the ROI (region of interest) in each single slice were conducted and the processed volume data was transferred into the 3-D Slicer. After resegmentation, a set of labeled maps of the ROI were produced. Based on these maps, the 3D surface models of the tissues of interest were constructed. Four groups of paranasal sinuses, nasal septa, middle and inferior turbinates, temporal bones, tympanic cavities, mastoid air cells, sigmoid sinuses, and internal carotid arteries were reconstructed successfully. These models show spatial relationships and orientation between them. The results show that the 3-D Slicer may be used for the 3D visualization of parts of anatomic structures in the nose and temporal bone based on the first Chinese virtual human data, and thus, can facilitate the observation and understanding of the anatomic structures in this area.

Adult↗
PubMedDate not supplied

Temporal bone fractures and cholesteatoma.

Extralabyrinthine fractures of the temporal bone offer the opportunity for squamous epithelial invasion of the middle ear, petrous pyramid, and mastoid air-cell system as a late complication. Cholesteatoma, secondary acquired in this situation, can be very aggressive and difficult to manage surgically, particularly where the temporal bone air-cell system is well developed. Polytomography is extremely helpful in determining the sites of fracture and in fashioning the surgical approach. Three cases are presented to illustrate the problems in diagnosis and surgical management.

Accidents, Traffic↗
PubMed1988

Temporal bone pathology of metastatic T-cell lymphoma.

Metastatic lymphoma involving the temporal bone is a rare tumour. A review of the English literature revealed only 13 reported cases. The common metastatic sites within the temporal bone are bone marrow and the internal auditory canal (IAC). Non-Hodgkin lymphoma has a tendency to infiltrate to the inner ear and middle ear, with bone marrow involvement. Recent advances in immunology have redefined the malignant lymphoma as a neoplasm of the immune system that has involved T and B cells. We present a case of non-Hodgkin T-cell lymphoma that metastasized to the temporal bone and central nervous system.

Humans↗
PubMedDate not supplied

Clinical significance of partial volume averaging of the temporal bone.

The effects of partial volume averaging on computed tomographic images of temporal bone structures were evaluated. The models chosen for study included a cadaver stapes, two metallic prosthetic stapes, and a formalin-fixed temporal bone. The studies measured the changes in apparent dimension and Hounsfield units with incremental filling of voxels with metallic densities, changes in the angle of tomographic section in relation to small bony structures, and the effects of soft-tissue silhouetting. The clinical significance of these changes is demonstrated by examples of this phenomenon seen in actual patient examinations. This study confirms that partial volume averaging is one of the primary limitations in resolution of small structures of the temporal bone.

Evaluation Studies as Topic↗
PubMed1988

Usher's syndrome, temporal bone pathology.

The histological findings in the right temporal bone of a 65-year-old deaf and blind man are presented. The subject suffered from the autosomal recessive Usher's syndrome, as did 2 of his 5 siblings. They are the offspring of a consanguineous marriage. This man died from an intra-abdominal hemorrhage. Within 3 h after death the temporal bones were donated for study and were processed for histopathological examination.

Aged↗
PubMed1991

Histopathology of the temporal bones in thanatophoric dysplasia.

The pathological findings of temporal bone in two cases of thanatophoric dysplasia were reported. Thanatophoric dysplasia is classified into type 1 and type 2, each of which has been reported to show specific clinical and radiographic-findings. The present study revealed that each type also showed specific characteristic in the structure of the temporal bones. The developmental mechanisms of hearing impairment in this disease were also discussed on the basis of the pertinent literature.

Autopsy↗
PubMed1986

Poorly differentiated fibrosarcoma (spindle cell sarcoma) involving the temporal bone.

A case of metastatic fibrosarcoma of the temporal bone was studied histopathologically. The primary site of this tumor was the posterior neck region. The initial major symptom of the patient was a left facial nerve paralysis. Although the patient underwent a suboccipital posterior craniectomy, radio-, and chemotherapy, she eventually died from multiple metastases. Histological examination of the temporal bones showed an extensive tumor invasion in the external auditory canal, middle ear cavity, middle ear muscle, tympanic membrane, mastoid cavity, petrous apex, facial nerve, and superior division (distal segment) of the vestibular nerve (left ear). The route from the stylomastoid foramen to the superior division of the vestibular nerve via the facial nerve canal could be one of the possible passages of tumor invasion.

Adult↗
PubMed2007

Combined petrosal approaches in the management of temporal bone meningiomas.

OBJECTIVES: To evaluate the indications and outcomes of the combined petrosal approaches in the surgical management of temporal bone meningiomas. STUDY DESIGN: Retrospective chart review. SETTING: University teaching hospital. PATIENTS: Adults with temporal bone meningiomas. INTERVENTION(S): Meningioma removal using a combined petrosal approach. MAIN OUTCOME MEASURE(S): Cranial nerve outcomes, complications, completeness of resection, and recurrence rates. RESULTS: Forty-nine patients underwent surgical excision of a temporal bone meningioma between 1996 and 2004 at our institution. Nineteen of these patients required a combined petrosal approach for excision. The most common presenting complaints were balance disturbance, 11 (58%); hearing loss, 10 (53%); headache, 10 (53%); and tinnitus, 9 (47%). The most common tumor origin was of the petrous ridge (14; 74%). Average tumor size was 3.1 cm. Complete resection was possible in 17 (89%) patients. Upper cranial nerve (III-VI) function was improved in two (11%) patients and worsened in three (16%) patients. Lower cranial nerve (IX-XII) function improved in one (5%) patient and was worsened in one (5%) patient. Postoperative facial nerve function was Grades I to II in 16 (84%) patients and Grades III to IV in 1 (5%) patient at last follow-up. Hearing data were available in 14 patients. Of those patients, 11 (85%) had serviceable hearing after surgery. The most common surgical complication was a cerebrospinal fluid leak, with three (16%) incidences. There were no reported incidents of stroke, death, or meningitis in the cohort. CONCLUSION: The use of the combined petrosal approach for temporal bone meningioma resection results in favorable outcomes for the patient. The incidence of complications is acceptably low, and cure rates are high.

Adult↗
PubMed2002

Major and minor temporal bone abnormalities in children with and without congenital sensorineural hearing loss.

OBJECTIVE: To determine the extent of correlation between sensorineural hearing loss (SNHL) and abnormal temporal bone anatomy in children. DESIGN: Axial and coronal high-resolution computed tomographic scans of the temporal bones of 247 children (494 ears) aged 2 months to 15 years with and without SNHL were blindly reviewed. The presence or absence of mild or severe cochlear dysplasias, vestibular dysplasias, and an enlarged vestibular aqueduct (VA) were recorded. The width of the VA was measured. The height, width, and length of the internal auditory canal (IAC) were measured, and abnormalities were described as narrow, widened, or bulbous. Clinical information was then reviewed to determine the presence or absence of a congenital syndrome and/or SNHL, and historical factors that might be responsible for SNHL. MAIN OUTCOME MEASURE: The relationship between radiographic findings and SNHL. RESULTS: One hundred thirteen patients (185 ears) had SNHL. Significant abnormal temporal bone anatomy in children with vs without SNHL included major cochlear and vestibular dysplasias (17% vs 0%; P<.001), enlarged VA (>2 mm) (5% vs 0%; P<.001), and narrow IAC (< or =2 mm) (4% vs 1%; P=.03). The average IAC width (4.85 vs 5.02 mm), height (4.39 vs 4.62 mm), and length (11.22 vs 11.44 mm) were not statistically different between children with vs without SNHL. In children with vs without SNHL, neither a widened (0.5% vs 3.6%) nor a bulbous (9% vs 8%) IAC was seen more often in children with SNHL. In ears with SNHL, the presence of a congenital syndrome significantly increased the risk of cochlear and vestibular abnormalities of the temporal bone (45% vs 14%; P<.001), including IAC abnormalities (30% vs 2%;P<.001), which overall were more commonly seen in children with (20%) vs without (3%) a congenital syndrome regardless of the presence of SNHL. No children with an enlarged VA had a congenital syndrome. CONCLUSIONS: Well-established temporal bone abnormalities such as cochlear and vestibular abnormalities and a grossly enlarged vestibular aqueduct are significantly found in children with SNHL. A narrow IAC is found more often in children with vs without SNHL. No significant correlation is found between SNHL and radiographic findings of a widened or bulbous IAC. In children with a congenital syndrome, more IAC abnormalities were seen, regardless of the presence of SNHL. In children with SNHL, the presence of a congenital syndrome increases the likelihood of a cochlear or vestibular abnormality.

Adolescent↗
PubMedDate not supplied

Temporal bone histopathology of osteopetrosis.

The histopathology of the temporal bone of an eight and one-half-year-old girl with osteopetrosis (Albers-Schönberg disease) was studied to evaluate the pathogenesis of its frequent complications in hearing and facial nerve function. The patient was blind and had acute otitis media, but facial paralysis was not noted. Although the size of the temporal bone pyramid was markedly increased due to enormously thickened periosteal layer, changes in the endosteal and endochondral layers were less marked. Exostotic growth of periosteal bone was seen in the middle ear wall, and the tympanic cavity appeared to be narrowed. At the oval window region, the facial nerve was pushed down towards the stapes due to extreme overgrowth of periosteal bone of the epitympanum, and the superstructure of the stapes was imbedded deeply into the dislocated facial nerve and had strongly compressed it. Although the footplate was free from ankylosis, the crus of the stapes appeared to be immobilized because it was lodged in the facial nerve. Such changes appeared to be the pathogenesis of one form of facial nerve paralysis and conductive hearing loss associated with osteopetrosis.

Child, Preschool↗