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PubMed1977

Reconstruction following temporal bone resection.

The aggressive initial treatment of external auditory canal and middle ear malignancies using ablative surgery in the form of temporal bone resection combined with postoperative curative doses (6,000 rads) of irradiation has resulted in meaningful palliation and a seeming increase in cure rates for these lesions. This combined therapy regimen has placed new demands on the wound of the temporal bone resection and subsequently necessitated development of a more substantial reconstructive effort. Hypoglossal nerve crossover has proved to be an efficient means of facial reanimation following temporal bone resection, with minimal morbidity associated with the loss of motor function to one half of the tongue. The composite posterior cervical flap, including a portion of trapezius musculature, has satisfied both the functional and cosmetic needs of this combined therapy program.

Adolescent↗
PubMed1994

Cloning and sequencing of genomic DNA extracted from archival human temporal bone sections.

Cloning techniques allow the engineering and production of highly purified DNA. Further advances in molecular biology have provided the means to identify DNA sequences in a rapid fashion. Sequencing methods can identify mutations, deletions, polymorphisms, or confirm a known genetic sequence. The use of these techniques in clinical medicine has made it possible to accurately diagnose infectious diseases and determine the molecular etiology of many genetic disorders and malignancies. In this study, DNA extracted from archival, celloidin-embedded temporal bone sections has been cloned and sequenced using these techniques. We amplified, cloned, and sequenced varicella-zoster viral DNA extracted from archival temporal bone sections from patients who had herpes zoster oticus. The application of cloning and sequencing techniques to DNA extracted from archival temporal bones provides the methodology to study temporal bone pathology at the molecular level.

Base Sequence↗
PubMedDate not supplied

Direct sagittal computed tomography of the temporal bone.

A technique of obtaining direct sagittal (lateral) CT images of the temporal bone is described, and the normal sagittal CT landmarks are illustrated. Using this technique, structures seen to advantage by lateral polytomography may now be imaged by CT. The ability to scan the temporal bone in the sagittal plane should be a useful adjunct to coronal and axial images.

Humans↗
PubMed1976

A comparative study of the temporal bone in three populations of man.

A comparative study was made to determine race and sex differences in the temporal bone, to investigate growth relationships, and to establish a basis for phylogenetic studies of the temporal bone and the temporal lobe of the brain. Data on Eskimo, Indian, and white crania were collected from radiographs and directly from the skulls. Of the 25 variables studied, only the minimum diameter of porus failed to demonstrate some difference among the races. Variation between sexes was found for all measurements except the cranial base angle (of deflection) and three angles related to the petrous pyramids. Correlation coefficients indicated that none of the angles are related in any consistent manner to the other variables studied. This is interpreted as further evidence of cranial base stability. The Indians have the lowest, longest squamae, differing most from the whites. The position of squama is more anterior in the Eskimos. Females of each race possess more anteriorly positioned squamae than males. When the squama is more anteriorly located, the porus is in a more posterior position within the squama itself. Strong race variation exists in the shape of porus. In order to establish a basis for phylogenetic studies of the temporal lobe of the brain better reference points for reflecting its size and shape must be found.

Adult↗
PubMed2000

[Giant osteoma of the temporal bone with otitis media: a case study].

A 71-year-old female presented with a giant osteoma of the right temporal bone and otitis media. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of the giant osteoma. An operation was performed to alleviate the difficult-to-treat otitis media and to address the related cosmetic problem. During the operation, three-dimensional CT (3D-CT) was very helpful in understanding the relationship between the tumor and the peripheral structures. Removal of the tumor improved the patient's otitis media. Osteoma of the temporal bone is rare. Only twenty-one cases of mastoid osteoma have been reported in Japan. In the present study, we review osteomas of the temporal bone and discuss their management.

Aged↗
PubMed2004

Relationship of petrous temporal bone pneumatization to the eustachian tube lumen.

OBJECTIVES/HYPOTHESIS: Objectives were to determine the incidence of petrous apex pneumatization and to define the relationship between a pneumatized petrous temporal bone and the eustachian tube lumen. STUDY DESIGN: Retrospective study with institutional review board approval including only adult patients. METHODS: One hundred head computed tomography (ct) scans and 204 petrous temporal bone CT scans performed at a tertiary teaching hospital were reviewed. The two senior authors (s.h.s., p.c.s.) independently reviewed the petrous temporal bone CT scans for grade of pneumatization. Pneumatized CT scans were then reviewed for the presence of a direct communication with the eustachian tube lumen. Significance was determined using the chi test and Pearson correlation of ranks. RESULTS: The incidence of peritubal cells opening into the eustachian tube anterior to the tympanic orifice was 92%. CONCLUSION: The direct communication of peritubal cells with the bony eustachian tube may play a role in the development of persistent cerebrospinal fluid rhinorrhea after cerebellopontine angle surgery.

Adult↗
PubMed1993

Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen therapy.

Radiation necrosis is a major complication of surgery or trauma in a previously irradiated field. Although it may occur in any location, the most common region affected is the head and neck. Osteoradionecrosis (ORN), the involvement of bone with radiation necrosis, occurs most frequently in the mandible, and has been well described. Involvement of the temporal bone, although less frequent, is nonetheless a difficult problem in management. Described herein is a case of ORN of the temporal bone treated with adjunctive hyperbaric oxygen therapy with complete resolution. This is followed by a discussion of the pathophysiology, presentation, and management of osteoradionecrosis of the temporal bone, including the role of adjunctive hyperbaric oxygen in the treatment regimen.

Adult↗
PubMed1986

Gunshot injuries of the temporal bone.

Concurrent with the increase in handgun crime in the United States is a rising incidence of gunshot wounds to the temporal bone. These injuries present challenging diagnostic and management problems to the otolaryngologist. A timely multicenter review of this entity revealed 22 cases evaluated and treated by the authors between 1975 and 1984. A wide variety of injuries were encountered, involving anatomic structures within or contiguous with the temporal bone. These included: eight intracranial injuries; 11 traumatized facial nerves; seven vascular wounds; 19 mastoid, middle, or inner ear injuries; and 11 cases of damage to the external auditory canals. A rational scheme for immediate and long-term management of each type of injury is outlined. Illustrative cases representing vascular, neural, temporal bone, and central nervous system injury are presented.

Adult↗
PubMed2003

Presbycusis: a human temporal bone study of individuals with flat audiometric patterns of hearing loss using a new method to quantify stria vascularis volume.

OBJECTIVE: The purpose of this study was to determine the prevalence of stria vascularis atrophy in individuals with presbycusis and flat audiometric patterns of hearing loss. Individuals with presbycusis have historically been categorized by the shape of their audiograms, and flat audiometric thresholds have been reported to be associated with atrophy of the stria vascularis. Stria vascularis volume was not measured in these studies. STUDY DESIGN: Retrospective case review. METHODS: Archival human temporal bones from individuals with presbycusis were selected on the basis of strict audiometric criteria for flat audiometric thresholds. Six temporal bones that met these criteria were identified and compared with 10 temporal bones in individuals with normal hearing. A unique quantitative method was developed to measure the stria vascularis volume in these temporal bones. The hair cell and spiral ganglion cell populations also were quantitatively evaluated. RESULTS: Only one of the six individuals with presbycusis and flat audiometric thresholds had significant atrophy of the stria vascularis. This individual with stria vascularis atrophy also had reduced inner hair cell, outer hair cell, and ganglion cell populations. Three of the individuals with presbycusis had spiral ganglion cell loss, three individuals had inner hair cell loss, and all six individuals had outer hair cell loss. CONCLUSIONS: The results of this investigation suggest that individuals with presbycusis and flat audiometric patterns of hearing loss infrequently have stria vascularis atrophy. Outer hair cell loss alone or in combination with inner hair cell or ganglion cell loss may be the cause of flat audiometric thresholds in individuals with presbycusis.

Adult↗
PubMedDate not supplied

Computed tomography of temporal bone specimens. A test of the resolution capability.

Ten deep-frozen temporal bone specimens were subjected to computed tomography (CT) in five different projections. The possibility of identifying small structures, such as the ossicles and aqueductal lumina, was assessed. In addition, the semicircular canals were measured. Subsequently corresponding measurements were carried out on plastic casts of these specimens for comparison. A temporal bone specimen is well suited as a test object for evaluating the detectability of small and dense natural structures by CT.

Ear Ossicles↗
PubMed1990

Acoustic neuroma: anatomo-clinical correlations in the posterior wall of the temporal bone.

A morphometric study of relationships among cranial nerves V-VI-VII-VIII-IX-X-XI-XII and the posterior wall of the temporal bone was done in 58 specimens. Large variations occurred in measurements. Results were correlated to a clinical study of 30 patients undergoing surgery for removal of acoustic neuromas. No correlations could be found between size and shape of external auditory meatus (E.A.M.) and internal auditory meatus (I.A.M.) in the same temporal bone. Mean distances from the point where cranial nerves enter the temporal bone to the I.A.M. were: trigeminium nerve, 7.8 mm; abducent n., 15.2 mm; hypoglossus n., 21.4 mm; and glossopharyngeal n., 5.3 mm. Although the jugular foramina is the closest structure to the I.A.M., cranial nerves IX-X-XI were never clinically impaired in all 30 patients studied here. Clinically diagnosed trigeminium nerve impairment occurred more often than facial paralysis (33.3% against 20% of patients). It seems that motor fibers are more resistant to tumoral compression and distension.

Ear, Inner↗
PubMed1983

Cochlear aqueduct radiographic anatomy in temporal bone preparations and in sudden hearing loss.

Sudden sensorineural hearing loss appears to have many possible etiologic factors. Shea has presented work indicating that a large cochlear aqueduct (CA) is frequently present on the side of an idiopathic sudden sensorineural hearing loss (ISHL). However, Valvassori, on performing temporal bone tomographic studies on several hundred patients complaining of ISHL, has not found enlargement of the CA in a statistically significant number of these cases. In an attempt to resolve this discrepancy, a single blind study was performed utilizing temporal bone polytomography to evaluate the presence or absence of the CA in 22 adult patients. One-half of these patients had a history of ISHL, while the remaining patients had other complaints as an indication for tomography. In all cases, the CA was identified. The CA was felt to be enlarged in 1 patient suffering from ISHL, in the nonaffected ear of 1 patient with unilateral ISHL, and in 2 control patients. There was, therefore, no positive correlation between CA enlargement and the occurrence of ISHL. In order to further elucidate the radiologic anatomy of the CA, 9 pairs of adult temporal bones removed at autopsy were studied by polytomography after cannulation and injection of radiopaque material. Measurements of the dimensions of the CA and its radiographic anatomy are discussed and compared to measurements obtained from histopathologic evaluation of the temporal bone.

Adult↗
PubMed1983

A systematic technique for comprehensive evaluation of the temporal bone by computed tomography.

A systematic method for comprehensive visualization of the temporal bone structures using thin-section, high-resolution computed tomography (CT) was developed. In relation to the anthropologic baseline (0 degrees), four separate tomographic planes of 0 degrees, 30 degrees, 70 degrees, and 105 degrees were each found to optimize different aspects of temporal bone evaluation with significant reduction in the radiation dose to the lens. Virtually all patients were able to maintain the necessary head positioning that allows for both direct coronal and axial sections. It is concluded that in the majority of cases, thin-section, high-resolution CT can replace polytomography, although the examinations may be complementary in the evaluation of certain abnormalities.

Cornea↗
PubMed1991

Otosclerosis: the University of Minnesota temporal bone collection.

A study of 1452 human temporal bones revealed a previously unpublished material of 144 bones with otosclerosis. After exclusion of infants and individuals of races other than white, the incidence of otosclerosis was 12.75%. Of the bones with otosclerosis, 56.1% belonged to men and 43.9% to women. The incidence of clinical and histologic otosclerosis was practically the same for men (44.7% to 55.3%) as for women (47% to 53%). However, the incidence of bilateral otosclerosis was higher in women (88.9%) than in men (65.2%). Bilateral otosclerosis was present in 75.6%, whereas it was unilateral in 24.4%. Sixty-six (66) ears (45.8%) had clinical otosclerosis, whereas 78 (54.2%) had histologic otosclerosis--frequently unifocal lesions. The most common site was anterior to the oval window (117 ears, 81.25%), followed by round window niche (52 ears, 36.11%), apical and medial cochlear wall (31 ears, 21.52%), and anterior wall of the internal auditory canal (27 ears, 18.75%). The activity of lesions was directly related to their size. Smaller lesions were predominantly inactive, whereas medium and larger lesions were predominantly active. There was a positive correlation when the size of the lesions, activity, and degree of cochlear endosteal involvement were compared with bone conduction thresholds (37 cases). Correlations between size and activity, and between activity and associated sensorineural hearing loss did not necessarily follow the sequence of an initial active stage (spongiotic) to a final inactive one (sclerotic). Comparison of cases of otosclerosis with equivalent age groups of the normal population yielded worse bone conduction thresholds for the otosclerosis cases only in the age group 60 to 69 years and older. Comparison of average bone conduction thresholds between bones with one site of endosteal involvement (28.26 dB HL) revealed no significant differences. Bones with two or more sites of endosteal involvement had significant differences. Bones with two or more sites of endosteal involvement had significantly worse bone conduction thresholds (62 dB HL). The overall results are not suggestive of an association of sensorineural hearing loss with otosclerosis without stapedial fixation.

Adolescent↗
PubMed2007

[Conventional tomographic investigations of the reconstructed middle ear in temporal bone specimen].

BACKGROUND: In modern reconstructive middle ear surgery imaging plays an essential role as a diagnostic tool, especially in pre-operative planning. Nowadays imaging of surgical results as a matter of quality control in post-operative follow-up becomes more important. MATERIAL AND METHODS: Conventional tomography was performed in 10 temporal bone specimen using the CommCat IS 2000-system in order to evaluate anatomical structures and inserted middle ear prostheses (PORP/TORP). This imaging technique has not been used in middle ear surgery beforehand. RESULTS: Using conventional tomography characterization of anatomical structures of the temporal bone as e. g. the semicircular canals appeared to be of superior quality to comparable conventional radiographic imaging. Concerning imaging quality (contrast; resolution) conventional tomography allowed similar findings like computed tomography (CT)-scans in some of the investigated specimen while showing inferior sharpness quality due to technical reasons. Further advantages of conventional tomography in contrast to CT were the requirement of just 2.5 % of the CT's irradiation exposure, lack of metallic artefacts caused by implanted prostheses and the feasibility of distance- and angle-measurement of inserted prostheses towards the tympanic membrane which coincided extensively with the temporal bone preparation. CONCLUSIONS: Conventional tomography enables detailed anatomical imaging of the temporal bone region which outperforms conventional radiographic imaging, requires less irradiation dose than CT and helps avoid problems like metallic artefacts. This technique enhances immediate quality-control and seems to be therefore a promising tool for postoperative evaluation after reconstructive middle ear surgery.

Contrast Media↗