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PubMed1985

Surgical treatment of brain herniation into the middle ear and mastoid.

A series of thirty-five patients operated on for brain herniation into the middle ear and mastoid is presented. The etiologic factor was felt to be previous surgery in twenty-six cases, head trauma in four cases, chronic otomastoiditis in four cases, congenital dehiscence of the tegmen in one case, and subdural empyema in one case. Diagnosis and treatment of brain herniation are discussed. The mastoid approach for repair of tegmen defects from below with the use of homologous cartilage or autologous cortical bone is advocated. A combined procedure using the transmastoid approach plus a mini-craniotomy of the temporalis squama is suggested as an alternative treatment to middle cranial fossa repair for larger cerebral hernias.

Adolescent↗
PubMed1985

Does drill noise during mastoid surgery affect the contralateral ear?

Drill-generated noise during chronic ear surgery, as well as surgical trauma, has been incriminated as a cause of sensorineural hearing loss in the operated ear. The contralateral ear is subjected to the drill noise but is spared the surgical trauma. Sixty-two patients who had undergone different mastoid operations served as the basis for this study. The average drilling time during surgery was 45 minutes. Sound pressure levels did not exceed 84 dB in the operated ear and 82 dB in the contralateral ear. Though some sensorineural hearing loss was found in the operated ear in fourteen patients, no changes in hearing were found in the contralateral ear. It is suggested that there is no damage exclusively due to the drill noise during mastoid surgery.

Hearing Loss, Noise-Induced↗
PubMed1984

Vibrotactile threshold for hairy skin and its transformation into equivalent bone-conduction loss for the mastoid.

Vibrotactile thresholds for the glabrous skin of the hand and for the hairy skin of the arm are investigated as a function of frequency in the range from 40 to 2 000 Hz, using a heavy vibrator. These thresholds are expressed as equivalent bone-conduction loss and compared with vibrotactile thresholds determined with bone vibrators on the arm and mastoid for normally hearing and severely hearing-impaired subjects. The results are used to predict the vibrotactile threshold of the hairy skin of the mastoid under conditions of severe hearing impairment and deafness. The frequency characteristics of a number of vibrators are discussed with respect to their suitability for skin stimulation.

Adolescent↗
PubMed1983

[Obliteration of the mastoid cavity with porous tricalcium phosphate ceramic. Results 12 and 18 months after ceramic implantation in the hypotympanon of the pig].

The paper reports on the obliteration of mastoid cavities with resorbable tricalcium phosphate ceramic. As a model, we chose the pneumatic air cell system of the pig's hypotympanon, which resembles the human mastoid. At the time of surgery, the specimens were 10-12 weeks old. In a first group the cells of the hypotympanon were totally removed and the operation cavity was obliterated with adjacent layers of porous tricalcium phosphate ceramic. In a second group of specimens the air cell system was partly removed, leaving the apical part of the hypotympanon intact; the operation cavity was obliterated again with porous tricalcium phosphate ceramic. After 12 and 18 months survival the hypotympanons were removed and prepared for histological investigations. Those ceramic plates, lying close to the bony shell were strongly resolved and replaced by new bone. Other ceramic plates, however, especially those in the center of the implant, showed few signs of resorption and bony remodelling. Inside the ceramic implant there was hardly connective tissue. The space between the still unsolved ceramic plates was filled up with new bony tissue. This bone was partly structured and adjoined directly to the ceramic. The ceramic was integrated into the new bony tissue without any sign of an inflammation.

Animals↗
PubMed1980

The history of mastoid surgery.

Adam Politzer wrote this article on the history of mastoid surgery for inclusion in Volume II of his History of Otology, Enke Verlag, Stuttgart, 1913. Politzer reviews the decades before antibiotics when the simple or complete mastoidectomy was performed in cases of acute mastoiditis in which abscess formation was suspected; such timely surgery after prevented extensive osseous destruction and also often-fatal meningitis and sinus thrombosis. So-called "radical" surgery began when surgeons realized that simple exposure of the antrum was inadequate to control chronic infection involving the middle ear, ossicles, and meatal walls. "Modified radical" surgery evolved from the attempt to preserve hearing, canal plasty from the attempt to prevent postoperative canal stricture. Politzer describes the surgery designed to close the tympanic ostium of the Eustachian tube and the application of skin grafts to the operative sites.

Europe↗
PubMed1982

Mastoid development in ancient and modern populations. A longitudinal radiological study.

The effect of otitis media on the human mastoid process in a common milieu over a millennium was evaluated by comparing two present and four ancient populations. Temporal bone pneumatization patterns indicate that otitis media and mastoiditis existed in antiquity, and there were more altered pneumatization patterns in skulls from the era following European contact than from eras before European contact. Pneumatization patterns were similar in ancient skulls and in a preponderantly white male population mostly born before antibacterial availability. Both ancient and modern pre-antibacterial era temporal bones show more effect of otitis media during childhood than is found in present day schoolchildren. Reasons for differences are explored. It is inferred that upper respiratory tract infections were prevalent in the Upper Missouri River Basin during the past millennium. Furthermore, microbiological agents with virulence similar to today's flora were prevalent in this region more than 1,000 years ago.

Adolescent↗
PubMed1982

[Subacute and chronic mastoiditis in the elderly: report on 10 cases including 5 with a Bell's palsy complication (author's transl)].

Ten elderly patients with subacute or chronic mastoiditis, including 5 with a complication Bell's palsy, were treated. 1) mastoid infections in elderly patients can present the typical characteristics as seen in younger subjects, this being the case in 4 of the 10 cases. 2) The findings in the other 6 patients confirmed facts, that are known or suspected, relating to the sometimes extremely serious and rapidly progressive nature of the affection, due to almost total lack of defences of the organism in elderly patients, often also diabetic, where the causal germ was invariably pyocanic. 3) In 3 cases, after removal of large amounts of wax with great difficulty, there was the very rapid development of a true malignant otitis externa with a Bell's palsy, and extensive bone involvement extending well beyond the region of the tympanic cavity.

Aged↗
PubMed1982

[Complete obliteration of the mastoid apophysis with an artificial material. A concept for the prevention of the recurrence of cholesteatoma].

Recurrences of cholesteatoma may occur, following closed operation techniques, if retraction pockets or matrix inadvertently left in the tympanic space invade the exenterated mastoid cavity. The precondition for such recurrence is the existence of the exenterated cavities, which serve as "nesting sites" for the matrix or the retraction pockets. These recurrences can be avoided by obliterating the mastoid cavity behind a reconstructed posterior ear canal wall with a non-resorbable material (plastic bone cement) and by uniting the lateral part of the attic with the outer ear canal. This will definitely prevent the exenterated spaces from the being invaded by any recurrence. The operation technique is described.

Cholesteatoma↗
PubMed1981

[Projection of the sigmoid sinus onto the lateral surface of the mastoid portion of the temporal bone in young children].

In newborns and in children up to 3 years of age died of various causes (excluding otogenic diseases) 130 roentgenograms of the temporal bones were studied with a preliminary contrasting of the sigmoid sinus. A definite dependence in the position of the sigmoid sinus was noted: from the birth up to 3 years of age, from the posterior mastoid parts of the temporal bones the sigmoid sinus approaches its anterior parts. At an expanded form of pneumatization of the mastoid process in children (1-3 years of age) the sigmoid sinus in 82% of cases is projected in posterior parts of Chipaux's triangle, and at an organic form of pneumatization in 35% of cases it is outside Chipaux's triangle.

Child, Preschool↗
PubMed1981

Effectiveness of prophylactic antibiotic treatment in mastoid surgery.

This article describes a prospective study of the effectiveness of prophylactic antibiotic treatment in preventing infection following mastoid surgery. Seventy-two patients who underwent surgery for chronic middle ear disease served as the basis for this study. Bacteriologic findings from middle ear discharge, showing aerobic and anaerobic bacteria, are reported. The patients were randomly classified into two groups, one undergoing surgery with preventive antibiotic treatment with clindamycin and gentamycin and the other undergoing surgery without antibiotic therapy. The early postoperative inflammatory complications are presented. No significant differences were found in the incidence of these complications between the two groups. In view of the results, the effectiveness of preventive antibiotic treatment in mastoid surgery is questioned.

Adolescent↗
PubMed1981

[Obliteration of the mastoid air cell system with porous tricalcium phosphate ceramic. An animal experiment of the bulla tympanica of the pig (author's transl)].

The paper reports on an animal experiment on the obliteration of mastoid cavities with tricalcium phosphate ceramic. The pneumatic air cell system of the bulla tympanica of pigs of 11-12 weeks of age was totally removed in one group of animals and partially removed in the second group. In this second group, apical part of the bulla was left intact. The operation cavity was then obliterated with adjacent layers of porous tricalcium phosphate ceramic. Histological sections wee evaluated for both groups of animals after survival time of 1, 3 and 6 months. Initially, an ingrowth of granulated tissue between the ceramic layers and into the porous surface can be observed. This dissolves the ceramic material, which is substituted by bony tissue. Pneumatic cells in the apical part of the bulla, which were left intact in the second group of animals, do not obliterate after the air supply has been cut off by sealing the basal part. Cystic cavities remain which contain a serous exudate. After 6 months, the mucous membrane of such cells shows signs of "sclerosis". Formation of spongy bony tissue with marrow spaces can be seen in most of the apical areas of the growing bulla. There is no formation of air-containing cells. It appears from our preliminary results obtained from animal experiments that porous tricalcium phosphate ceramic may be a suitable material for the obliteration of mastoid cavities.

Animals↗
PubMedDate not supplied

[The contribution of standard views of the mastoids in the treatment of cholesteatoma (author's transl)].

The authors consider than standard films of the mastoid (bilateral Schüller, mastoid tips displaced) are essential in all cases of chronic cholesteatomous otitis since they frequently provide the surgeon with useful information concerning appropriate management. Their opinion is illustrated by very convincing cases. Furthermore, they form part of personal hypotheses concerning the course and the interpretation of certain aspects.

Cholesteatoma↗
PubMed1995

High-resolution CT of mastoid sinus pneumocele with external auditory canal stenosis.

A 34-year-old man presented with tinnitus and conductive hearing loss. CT demonstrated an expansile, air-containing cavity contiguous with mastoid air cells, narrowing the external auditory canal. This is a case of symptomatic pneumocele resulting in an air collection beneath external canal lining, possibly related to an abnormality in mastoid fusion.

Adult↗
PubMed1995

[Morphological and morphometric study of the tympanic and mastoid portions of the fallopian aqueduct].

In surgery of the temporal bone the best way to avoid injuries to the facial nerve is to be acquainted with its location in all the surgical steps of the procedure scheduled. That is to say: an exact knowledge of its normal intratemporal run, having always in mind some characteristic landmarks, is absolutely essential. This work has been done through drilling 92 human temporal bones, measuring the length of both the tympanic and mastoidal segments and also considering the bending of the 2nd knee of the nerve. In the issue the mastoidal portion resulted the most straight (by half of the cases) whereas the tympanic one was slightly sloping downwards between the lateral semicircular canal upwards and the oval window below. Topographically has not been possible to establish neither a strict correlation between the location of the pyramide and the 2nd knee nor this knee was found by uns (in contrast to other AA's findings) at higher angle than 90 degrees in our specimen.

Culture Techniques↗
PubMedDate not supplied

[The mastoid surgery in children at the Doce de Octubre Hospital. Review of the years 1988-1991].

A study was made of 21 children with cholesteatoma and chronic otitis media between 1989 and 1991. We reviewed diagnostic tools, presurgical data, surgical procedures and results. Certain aspects of special relevance such as congenital anomalies and presurgical complications, are emphasized. The procedure of choice was mastoid tympanoplasty with the canal wall down, which is preferred in children. Hearing results were poor, partially caused by the process of bone resorption and by the surgical technique used. The incidence of persistent disease and recurrent cholesteatoma was high but we achieved a good control of the disease development because the canal wall down procedure allowed visualization and cleaning of the mastoid cavity.

Adolescent↗
PubMedDate not supplied

Musculoplasty for mastoid cavity obliteration in the capucine monkey.

In a series of musculoplasty in 12 ears in the capucine monkey the mastoid cavity was successfully obliterated in the early follow-up months, but showed no obliteration at one year. A control using a bovine collagen preparation showed similar results. Musculoplasty appears to carry the dual risk of burying residual cholesteatomatous disease by virtue of atrophy and shrinkage of the muscle flap, and reformation of the mastoid cavity.

Animals↗
PubMedDate not supplied

[Congenital cholesteatoma of the petrous process and mastoid: a report of two cases].

Congenital cholesteatoma are unusual. They may arise in different sites of the temporal bone: petrous process, middle ear and mastoid. Primary cholesteatomas originate from embryonary ectodermal inclusions but the pathogenesis is not clear and many different hypotheses regarding its origin have been suggested. The clinical diagnosis is not easy if the tympanic membrane is normal, and computerized tomography and magnetic resonance imaging are useful. We report two cases of congenital cholesteatoma: One located in the petrous process and the other in the mastoid without affection of the tympanic cavity.

Cholesteatoma↗
PubMed1996

Tumor-associated paralysis of the mastoid portion of the facial nerve: report of three unusual cases.

Tumors of the mastoid portion of the facial nerve are rare and often are misdiagnosed because they have subtle clinical manifestations. We have described three cases of tumor affecting the mastoid portion of the facial nerve seen in our hospital. In all cases, diagnosis proved problematic. Routine and careful use of imaging techniques and a certain amount of intuition are necessary to reach the correct diagnosis. Facial paralysis diagnosis requires histopathological examination following mastoidectomy.

Aged↗