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PubMed1983

Extended temporal bone resection.

A histologically benign tumor of the temporal bone became a life-threatening neoplasm. Previous surgical procedures and a course of radiotherapy failed to arrest the growth of the neoplasm. Our therapeutic objectives were fourfold: (1) ventilation of tumor histology; (2) total tumor removal without an increase of the neurological deficit; (3) watertight closure of the dural defect; and (4) aesthetically acceptable scalp reconstruction. These goals were achieved by performing temporal bone resection extending from the foramen lacerum to near the foramen magnum. The external soft-tissue defect was reconstructed with a contralateral scalp flap. The patient recovered satisfactorily from her surgery and achieved improvement of her ataxia and level of consciousness.

Cerebellar Ataxia↗
PubMed2003

[Giant cell tumor of temporal bone: a report of 7 cases].

OBJECTIVE: To investigate the clinical course, auxiliary examinations, histologic feature, diagnosis, differential diagnosis and treatment of giant cell tumor of temporal bone (GCTTB). METHOD: Seven cases of GCTTB, which arose in temporal bone, were collected from 1990 to 2002 and analyzed clinicopathologically. RESULT: Seven cases with the GCTTB are reported, including 3 females, 4 males. The age of 7 patients between 9 to 53 years. Five tumors located in right side temporal bone, two in left side temporal bone. One patients was pathological I grade, two I-II grade, and four II grade. The clinical course were different according to the position of the tumors: including tinnitus 6 cases, tinnitus with hear loss 5 cases(2 cases with anakus of trouble side ear), vertigo 1 case, facial paralysis with hear loss 1 case. Radical resections were performed in five cases and subtotal resections in two (recurrence, one year after operation, II grade pathologically). Postoperative Radiotherapy was conducted in three cases. CONCLUSION: Diagnosis of GCTTB is based on typical histologic features and imagine as well as clinical information. Complete surgical resection is believed to be the most suitable treatment for GCTTB and postoperative radiotherapy may be effective.

Adolescent↗
PubMed1997

Rapid decalcification of temporal bones with preservation of ultrastructure.

Decalcification of temporal bones, especially from primates, has routinely required long periods of time and has been a major deterrent to many types of morphological studies. In this investigation, temporal bones from the monkey, Macaca fuscata, were decalcified with ethylene diamine tetraacetic acid (EDTA) in a microwave oven. To isolate effects of microwaves on decalcification, tissue was fixed and embedded using routine methods; only decalcification was carried out in the microwave oven. The procedure is described in detail. Instead of months, decalcification was complete in two working days. Control procedures included decalcification at room temperature and use of a regular oven at a temperature equal to that reached in the microwave. The ultrastructure of cochlear tissue was equal to or better than that obtained with routine decalcification.

Animals↗
PubMed1994

The temporal bone in multiple myeloma.

Multiple myeloma is a malignant disease of the skeleton. Anatomically, any bone may ultimately come to be involved in a given case. In a literature review, no published series of temporal bone findings have been reported. In this study, oto-histopathologic changes associated with multiple myeloma are analyzed and reported in 15 temporal bones from 8 patients. The bone marrow of 13 temporal bones was involved by the tumor. Osteolysis was evident in 11 temporal bones. Serous otitis media (SOM) or purulent otitis media (POM) was seen in 13 ears with 12 showing mastoid effusions. Eight ears exhibited pathological changes in inner ears, including degeneration of the organ of Corti, atrophy of stria vascularis, decreased ganglion cells, and labyrinthine hydrops. The inner ear changes were most severe in 2 patients who had otologic symptoms. Infiltration of myeloma cells was not apparent in the middle ear mucosa or the inner ears.

Aged↗
PubMed1983

Temporal bone fractures. Review of 90 cases.

Of 1,300 consecutive head-injured patients admitted to the hospital over a 20-month time period, 118 were found to have skull fractures, of which 22% involved the temporal bone. These figures form part of a larger study of 90 temporal bone fractures treated over a six-year period from 1975 through 1981. The most common cause of a temporal bone fracture was a motor vehicle accident occurring in 40/90 (44%) patients. Pertinent physical findings, occurring alone or in combination, were a hemotympanum, bleeding from the ear canal, tympanic membrane perforation, facial paralysis, and CSF otorrhea. The diagnosis of temporal bone fractures is best made clinically and radiographically. The early care of temporal bone fractures is directed toward the treatment of CSF otorrhea and immediate onset facial paralysis. The delayed care is primarily concerned with hearing rehabilitation.

Adolescent↗
PubMed1996

Techniques for human temporal bone removal: information for the scientific community.

Human temporal bones provide an irreplaceable resource for study of the pathology and pathophysiology of disorders of hearing, balance, taste, and facial nerve function. Additional specimens are needed to study disorders for which there are few human specimens; to increase the number of specimens for a given disorder to understand the natural variability and expression of the disease entity; to evaluate the accuracy of otologic diagnoses and the efficacy of otologic treatment modalities; to apply newly available scientific methods, including immunohistochemistry and molecular biologic or molecular genetic techniques; and to teach the anatomy of the human ear and modern otologic surgical techniques. This article provides information for the scientific community concerning techniques for temporal bone and auditory brain stem removal, including intracranial and extracranial approaches and methods to minimize postmortem autolysis and cosmetic defects. Close collaboration between physicians and funeral directors will maximize the yield and utility of these valuable specimens for scientific inquiry and training.

Brain Stem↗
PubMed2003

The potential of a plastination specimen for temporal bone surgery.

OBJECTIVE: The benefits of plastination specimens in temporal bone surgery (TBS) were evaluated. METHODS: A formalin-preserved human temporal bone was drilled and dissected with the middle cranial fossa approach or the translabyrinthine (or transcochlear) approach. The specimen was thereafter subjected to silicon impregnation. RESULTS: The flexibility of the dura mater after plastination was maintained, and not only bony structures such as the auditory ossicles and semicircular canals but also soft tissues such as the facial nerve, internal carotid artery and the sinus attached to the dura mater were easily discriminated. CONCLUSION: The technique furnishes a persistently dry, odorless and durable specimen that allows handling and may serve as the most ideal specimen for anatomical learning of various approaches of TBS.

Carotid Artery, Internal↗
PubMed2002

Radiosurgery for paraganglioma of the temporal bone.

PURPOSE: To report the outcome of patients with paraganglioma of the temporal bone treated with stereotactic radiosurgery at the University of Florida. METHODS AND MATERIALS: Between January 1997 and June 1999, five patients with paraganglioma of the temporal bone were treated with Linac-based stereotactic radiosurgery at the University of Florida. The ages of the three female and two male patients were between 40 and 88 years (median, 49 years). Four patients were treated at initial presentation, and one had recurrent disease. Treatment volumes ranged from 4.9 cm3 to 18.4 cm3, with a mean of 10.84 cm3. The dose applied to the margin of the tumor varied from 12.5 to 15 Gy (median, 15 Gy). The treatment dose was specified to the 80% isodose shell in two cases and to the 70% isodose shell in three cases. The median follow-up time was 27 months, ranging from 14 to 50 months. RESULTS: One of four previously untreated patients had a relapse at the primary tumor site. Treatment failure occurred at the field margin 6 months after radiosurgery; the patient was subsequently treated with fractionated stereotactic radiotherapy and at the time of analysis had no evidence of disease, 21 months after initiation of salvage therapy. The patient treated at the time of recurrence after conventional radiotherapy had a local recurrence 40 months after radiosurgery. At the time of this recurrence, the patient had biopsy-proven metastatic disease in two cervical lymph nodes, and no salvage therapy was performed. All patients were alive at the time of the analysis, one with disease present. Presenting symptoms improved in two patients and stabilized in one. The two patients who had local recurrence develop had worsening of their symptoms. One patient had a cranial nerve V palsy develop 6 months after treatment, which resolved after a few months. CONCLUSIONS: In this series, the results with stereotactic radiosurgery are discouraging compared with our results with conventional fractionated radiotherapy in patients with paraganglioma of the temporal bone.

Adult↗
PubMedDate not supplied

[Usefulness of bone scintigraphy for staging in a case of histiocytosis of the temporal bone].

We present the case of a 43-year-old man diagnosed of insipid diabetes and hypogonadotropic hypogonadism in whom a right temporal bone lesion was observed in the control MRI, thus leading to his admission. A bone scintigraphy with 99mTc-HMDP showed increased uptake in the right temporal region with sphenoidal extension, coinciding with the MRI. In addition, increased uptake having less intensity and size was observed in the left temporal region. A biopsy on the newly appearing mouth ulcers in the jugal mucous was performed and showed Langerhan's cells, the diagnosis of histiocytosis X being confirmed. Six months later a new MRI indicated disease progression with bilateral temporal involvement. The bone scan findings in this case provided a more exact extension diagnosis of the disease than the MRI.

Adult↗
PubMed2001

Temporal bone histopathologic and genetic studies in Mohr-Tranebjaerg syndrome (DFN-1).

OBJECTIVE: To describe the temporal bone histopathologic and genetic abnormalities in a case of Mohr-Tranebjaerg syndrome. BACKGROUND: Mohr-Tranebjaezrg syndrome (DFN-1) is an X-linked, recessive, syndromic hearing loss, characterized by postlingual sensorineural hearing loss with onset in childhood, followed in adult life by progressive dystonia, spasticity, dysphagia, and optic atrophy. The syndrome is caused by mutations in the DDP (deafness/dystonia peptide) gene, which are thought to result in mitochondrial dysfunction with subsequent neurodegeneration. The temporal bone pathologic changes in this syndrome have not been reported. METHODS: Hearing loss developed in the patient at age 4, blindness at age 48, and dystonia at age 57. Genetic studies on peripheral blood showed a l51delT mutation in his DDP gene. He died at age 66. The right temporal bone was subjected to light microscopy and polymerase chain reaction-based analysis of the DDP gene sequence. RESULTS: There was near complete loss of spiral ganglion cells with loss of nearly all peripheral and central processes. Only 1,765 spiral ganglion cells remained (8.5% of mean normal for age). The organ of Corti (including hair cells), stria vascularis, and spiral ligament were preserved. There was also a severe loss of Scarpa's ganglion cells with preservation of vestibular hair cells. The population of geniculate and trigeminal ganglion cells appeared normal. Sequence analysis from temporal bone DNA showed the 15ldelT DDP gene mutation. CONCLUSION: Sensorineural hearing loss in Mohr-Tranebjaerg syndrome is the result of a postnatal, progressive, severe auditory neuropathy.

Child, Preschool↗
PubMed1990

Three-dimensional x-ray computed tomography of the temporal bone as an aid to surgical planning.

Three-dimensional x-ray computed tomography (3DCT) has been useful in planning surgical procedures involving craniofacial reconstruction, the pelvis, hip, spine, knee and shoulder. The clinical use of 3DCT in temporal bone surgery has not been evaluated. We used 3DCT to assess temporal bone anatomy in 9 patients. These cases evaluated two encephaloceles, two postinflammatory dehiscences, two temporal bone fractures, one glomus jugulare tumor, one acoustic neuroma, and one meningioma. We found 3DCT useful in these temporal bone applications as a supplement to standard two-dimensional CT scanning (2DCT). While 3DCT provided a better preoperative understanding of the underlying anatomy, no treatment was modified solely on the basis of the information derived from the 3-D presentation of data. We conclude that, although 3DCT images have some qualitative advantages over 2DCT techniques, their value in further defining temporal bone morphology must be evaluated against the cost entailed by their use.

Adult↗
PubMedDate not supplied

The internal acoustic meatus. Anatomic variations and relations to other temporal bone structures.

The internal acoustic meatus was evaluated in 97 temporal bone specimens, half of which were radiographed in different projections. Part of the material was also examined by multidirectional and computed tomography. Casts of the specimens were prepared and the meatuses were measured in different planes. The anatomic variations, especially in the transverse plane, and their relations to other structures in the petrous bone, were assessed. The meatus varied in shape, being mainly either long and thin, short and broad, funnel-shaped or pear-shaped. The pear-shaped meatus was practically always broad. The angle formed by the long axis of the meatus and the posterior wall of the pyramid varied inversely with the meatal length, a long meatus forming a small angle and vice versa. Large anteroposterior diameters were correlated to large meatal angles, but there was no direct correlation between meatal length and width. In addition, the meatal length was correlated to the perilabyrinthine and mastoid pneumatization and also to the dimensions of the pyramid.

Humans↗
PubMed1981

Preparation of small temporal bones for high-resolution light microscopy.

A technique was used for rapid processing of small temporal bones for high-resolution light microscopy, Temporal bones were decalcified in edetic acid and embedded in glycol methacrylate. Sections (thickness, 1 micrometer) were stained with a variety of stains that demonstrated cellular details not usually seen with conventional methods. This technique is suitable for routine histologic, histochemical, and radioautographic studies of small temporal bones.

Animals↗
PubMed2001

[Facial paralysis in temporal bone trauma].

OBJECTIVE: To study the cause and treatment of facial paralysis in temporal bone trauma. METHODS: A retrospective review of 28 patients with facial paralysis resulting from temporal bone trauma was conducted, House-Brackmann(H-B) system was used to evaluate the recovery of facial nerve function, U test was employed for statistic analysis. RESULTS: Twenty-six cases underwent following up facial nerve function of all patients was recovery partly after surgery, 46% cases reached H-B II, 84% cases reached H-B III, comparing facial nerve decompression within 4 months of injury to beyond 4 months of injury, recovery to H-B II or more of facial nerve function was 60% and 0%, respectively. The difference was significant(P < 0.05). CONCLUSION: Surgery decompression is effective on facial nerve palsy caused by temporal bone trauma. It is recommended that surgery decompression be carried out as soon as possible since a better prognosis is obtained if it is performed within four months after injury.

Adolescent↗
PubMed1999

Squamous cell carcinoma of temporal bone: reported on 33 patients.

BACKGROUND: This study assessed the treatment results of a series of 33 patients with squamous cell carcinoma (SCC) of the temporal bone and evaluated the efficacy of mastoidectomy combined with perioperative radiation therapy protocol. METHODS: Thirty-three patients with biopsy-proven SCC invaded to the temporal bone were reviewed retrospectively and staged into three subgroups according to the University of Pittsburgh TNM Staging System. There were 3 patients with Stage I and II disease(tumor confined to auditory canal), 17 patients with Stage III (tumor involving the middle ear or mastoid), and 13 patients with Stage IV(more extensive disease). Two patients were treated by surgery alone. Eleven patients received irradiation only, and the remaining 20 patients underwent combined surgery and perioperative radiotherapy. The surgical intervention included sleeve resection for patients with Stage I and II lesions and mastoidectomy for all patients with Stage III and IV lesions except 1 who had subtotal temporal bone resection. The radiation dose delivered was in the range of 3500 approximately 10 000 cGy, with an average dose of 6560 cGy. RESULTS: The five-year survival rate for the whole series was 51.7% by the life-table analysis. After being staged into three subgroups (ie, Stage I + II, Stage III, and Stage IV), the estimated five-year survival rates were 100%, 68. 8%, and 19.6%, respectively (p = 0.04). Radiation alone yielded a 28. 7% five-year survival, while combined surgery and irradiation gave a result of 59.6% (p = 0.80). For patients treated with planned combined therapy, the actuarial five-year survival rates were 72.7% (8/11) for Stage III disease and 12.5% (1/8) for Stage IV disease (p = 0.02). Twelve patients who died of disease did so of local recurrence (10 cases), cervical metastases (1 case), and liver metastases (1 case), with 70% of succumbing to their diseases within two years. Complications include osteonecrosis (n = 1), osteitis (n = 3), radiation dermatitis (n = 2), facial nerve palsy (n = 2), and delayed healing (n = 2). Data on clinical presentation and treatment modality were also analyzed. CONCLUSION: The results of mastoidectomy with removal of all gross tumor, combined with planned perioperative irradiation therapy, seems to be a useful approach for SCC of the temporal bone. This gives at least as good, and possibly better, five-year survival than temporal bone resection. The mastoidectomy procedure creates less operative morbidity and mortality. To facilitate the development of more effective means of treating advanced disease, an accepted staging system and cooperative group investigation is necessary.

Adult↗
PubMed1992

High-resolution CT of the temporal bone: a modified baseline.

High-resolution computed tomography (CT) of the temporal bone, particularly axial scanning on a baseline parallel to the orbitomeatal line, produces radiation exposure to the patient's lenses. The authors evaluated the radiation dose to the lens and the visualization of temporal bone structures with use of scanning along the orbitomeatal line and on a line parallel to the hard palate. Evaluation of visualization was performed by five radiologists, with high-resolution CT scans of 45 healthy patients, and the chi 2 test was performed for comparison. The change of the baseline from the orbitomeatal line to a line parallel to the hard palate decreased the radiation dose to the lens from 12.7 cGy to 0.274 cGy and improved visualization of the stapes superstructure and the tympanic portion of the facial nerve canal, although visualization of the incus body, incudostapedial joint, lateral semicircular canal, and oval window was of equal quality. Therefore, the authors recommend a new baseline parallel to the hard palate for use at high-resolution CT of the temporal bone.

Health Personnel↗
PubMed1997

Molecular temporal bone pathology: I. Historical foundation.

The application of molecular biology techniques to temporal bone research is resulting in rapid changes in our understanding of the fundamental mechanisms of auditory, facial nerve, and vestibular function. The use of the polymerase chain reaction, cDNA libraries, and in situ hybridization histochemistry, the determination of genetic defects, and the manipulation of transgenic animals are the molecular biology tools that are available to approach these research problems. Knowledge of the molecular pathology that results in the otologic and neuro-otologic dysfunction many of our patients experience is currently in its infancy. A review of the historical foundation of temporal bone pathology and the evolution of the application of cell and molecular biology methods to archival celloidin-embedded human temporal bone material is presented.

Animals↗
PubMed1996

Imaging findings of the developing temporal bone in fetal specimens.

PURPOSE: To trace the development of the normal fetal temporal bone by means of plain radiography, MR, and CT. METHODS: Eighteen formalin-fixed fetal specimens, 13.5 to 24.4 weeks' gestational age, were examined with a mammographic plain film technique, CT, and MR imaging at 1.5 T. Temporal bone development and ossification were assessed. RESULTS: The membranous labyrinth grows with amazing rapidity and attains adult size by the middle of the gestation period. The cochlea, vestibule, and semicircular canals are very prominent and easily recognized on MR images. The otic capsule develops from a cartilage model. Ossification of the otic capsule proceeds rapidly between 18 and 24 weeks from multiple ossification centers that replace the cartilaginous framework. The mastoid, internal auditory canal, vestibular aqueduct, and external auditory canal continue to grow after birth. CONCLUSION: The study of fetal developmental anatomy may lead to a better understanding of congenital disorders of the ear. Faster MR scanning techniques may provide a method for in utero evaluation of the fetal temporal bone.

Cartilage↗