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At least 649 records · Page 36Linked to original sources
PubMed2001

Squamous cell carcinoma of the temporal bone: a radiographic-pathologic correlation.

OBJECTIVE: To assess the utility of a previously proposed staging system for patients with primary squamous cell carcinoma of the temporal bone. METHODS: Retrospective chart review of 15 patients treated for squamous cell carcinoma of the temporal bone over a 13-year period at an academic tertiary referral center. A review of the medical and surgical records, radiographic studies, and surgical pathology reports allowed for an evaluation of the University of Pittsburgh staging system. Outcome analysis was performed on 13 patients with more than 24 months of follow-up. RESULTS: Radiographic and surgical pathology staging according to the University of Pittsburgh staging system correlated in 11 (73%) of 15 cases. The radiographic staging system was more accurate for larger (T3/T4) tumors than for smaller (T1/T2) tumors (83% vs 67%). When compared with patients with no evidence of disease, nonsurvivors were more likely to present with otalgia (67% vs 43%), facial nerve paralysis (33% vs 0%), and T3/T4 tumors (100% vs 14%). CONCLUSIONS: Pathologic staging by the University of Pittsburgh staging system closely correlates with patient outcome and is more sensitive than preoperative radiographic staging. Prognosis in squamous cell carcinoma of the temporal bone is largely determined by the extent of local disease at the time of presentation.

Aged↗
PubMed2006

Endolymphatic duct status during middle fossa dissection of the internal auditory canal: a human temporal bone radiographic study.

OBJECTIVE: Successful hearing preservation after acoustic neuroma resection is sometimes complicated by delayed hearing deterioration. The middle fossa approach appears to offer superior long-term hearing results when compared to the retrosigmoid surgical approach. The goal of this study is to investigate the hypothesis that internal auditory canal (IAC) drilling during middle fossa acoustic neuroma removal is associated with a lower incidence of endolymphatic duct (ELD) injury, a potential cause of delayed hearing loss (HL) known to accompany retrosigmoid hearing preservation dissection techniques. STUDY DESIGN: A human temporal bone anatomic and radiographic study complemented with a literature review. METHODS: Twenty human temporal bones were analyzed with high-resolution multislice computed tomography (HRMCT) and subjected to standard extended middle fossa IAC dissection with labyrinthine preservation and follow-up HRMCT for analyses of the ELD. RESULTS: Zero of 20 (0%) temporal bones were found to have violation of the ELD with preservation of the labyrinthine structures and the endolymphatic sac. Reviews of human and animal studies indicate that injury to the ELD may create endolymphatic hydrops, a known cause of hearing deterioration. CONCLUSION: The ELD is not vulnerable to injury during IAC dissection using the middle fossa approach. A previous radiographic study has shown that the ELD is violated in 24% of temporal bones during retrosigmoid dissection of the IAC. These findings support and may help explain other outcome studies that show that long-term hearing results are superior with the use of the middle fossa approach when compared to results following retrosigmoid dissection.

Cranial Fossa, Middle↗
PubMed1979

Surgical treatment of extensive tumors of the lateral face and auricular area by radical soft tissue and subtotal temporal bone excision with deltopectoral flap coverage.

A method of excision of extensive tumor in the parotid and peri-auricular area with a partial temporal bone excision in discontinuity, has been described. In selected tumors local control has been as satisfactory as following more radical en bloc soft tissue and temporal bone excisions and without significant morbidity or operative deaths. The results in 15 patients treated by this method are described. The authors believe that the small number of patients in this and other reported series does not accurately reflect the frequency of tumors which could be treated successfully by this method, but does reflect a reluctance to advise the better known radical en bloc temporal bone excision with its associated morbidity and operative mortality.

Ear Neoplasms↗
PubMed2005

[Effect of elastic pivot stable bite plate on treating irreducible temporal bone displacement of the temporomandibular joint].

OBJECTIVE: To investigate the effect of elastic pivot stable bite plate on treating irreducible temporal bone displacement of the temporomandibular joint. METHODS: Twenty-eight cases of irreducible temporal bone displacement of the temporomandibular joint treated with the elastic pivot stable bite plate from 2000 to 2004 were summarized. The ages of the patients ranged from 15 to 58 years including 11 men and 17 women. RESULTS: All the patients were treated for 1 month and followed up for 3 to 6 months. The effective rate was 87.51%. The patients who had shorter course of diseases obtained better effect than the patients who had longer courses of diseases. CONCLUSION: Elastic pivot stable bite plate is an effective alternative for treating irreducible temporal bone displacement of the temporomandibular joint and it exerts better effect on the patients that have short courses of diseases.

Adolescent↗
PubMed2003

[A radiolucency in the articular eminence of the temporal bone: an air bubble?].

A case is described in which the orthopantomogram by coincidence showed an anomaly of the left articular eminence of the temporal bone, which is based on an extremely pneumatised mastoid bone. Because of the medical history a CT-scan was made of both temporomandibular joints. The CT-scan showed an extremely pneumatized articular eminence at the left side. The orthopantomogram might show a radiolucency in the articular eminence of the temporal bone as a coincidental appearance. In cases with a positive medical history for pathological deformaties or in cases where surgery has to be performed on the articular eminence of the temporal bone further radiodiagnostic examination is indicated.

Aged↗
PubMed1995

Gunshot wounds of the temporal bone: a rational approach to evaluation and management.

Gunshot injuries of the temporal bone are uncommon but are being seen more frequently with the increasing incidence of violent crimes and use of firearms. A retrospective analysis of 43 consecutive patients treated at our institution with this injury was undertaken to determine the clinical symptoms, associated injuries, and treatment outcome. This is the largest series from a single institution treated by a single group during a brief period of time. Most of these patients had injury to various structures within and around the temporal bone, including hearing loss (29), intracranial injury (23), facial nerve injury (22), vascular injury (14), and mandible fracture (6). Ocular trauma and paralysis of cranial nerves V and IX, X, XI, and XII were rare occurrences. A rational approach to the evaluation and management of these injuries will be discussed in detail to optimize outcome.

Adolescent↗
PubMed2007

The radiographic prevalence of geniculate ganglion dehiscence in normal and congenitally thin temporal bones.

OBJECTIVE: To determine the prevalence of a dehiscent geniculate ganglion on routine temporal bone computed tomography (CT). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Two hundred seventy-eight consecutive temporal bone CT examinations for a total of 556 sides were reviewed. One hundred ninety-one sides were excluded. Reasons for exclusion included reconstructed coronal views, no coronal views, or a pathologic process, which involved the geniculate ganglion. Six examinations were from patients with clinical superior canal dehiscence confirmed by surgical repair or positive vestibular evoked myogenic potentials. Twenty-four scans were from patients with radiographic superior canal dehiscence confirmed by two independent readings. MAIN OUTCOME MEASURES: The incidence of geniculate ganglion dehiscence in patients with and without radiographic or clinical superior canal dehiscence. Dehiscent geniculate ganglion was defined as at least two consecutive cuts on a coronal CT showing no bone overlying the geniculate ganglion. RESULTS: The overall incidence of a dehiscent geniculate ganglion was 14.5% in the 365 sides reviewed. The incidence of a dehiscent geniculate ganglion is increased in patients with radiographic and clinical superior canal dehiscence as compared with normal patients and was significantly different by chi analysis (38.1 versus 11.4%). CONCLUSION: The presence of radiographic geniculate ganglion dehiscence is common. This finding has particular importance when the middle cranial fossa or subtemporal approach is used, as the facial nerve is more at risk especially when used to address superior canal dehiscence.

Adolescent↗
PubMed1985

Temporal bone pathology in congenital anomalies of the oval window and the facial nerve.

Temporal bones of six infants with congenital ear anomalies were examined for abnormalities of the oval window and facial nerve. These temporal bones were classified into two groups according to the degree of malformation: group A, those with atresia or absence of the oval window; and, group B, those with hypoplasia of the stapes and annular ligament. Group A, consisting of five ears, were associated with severe middle ear anomalies such as the abnormal course of the facial nerve and absence of the stapes. In group B, consisting of seven ears, the stapes were present and the facial nerve presented minor anomalies such as obtuse angulation at the first genu, central migration of the geniculate ganglion cells, ectopic muscles and a wide bony dehiscence of the facial canal around the oval window. Probable origin of the anomalies in group A could mainly be due to maldevelopment of the facial nerve during an earlier embryonal period while that of group B could have developed after the ninth week of the fetal period and are mostly localized along the second branchial arch.

Abnormalities, Multiple↗
PubMed1978

Infratemporal fossa approach to tumours of the temporal bone and base of the skull.

In spite of the development of a superior (middle cranial fossa) and posterior (translabyrinthine) approach to the temporal bone, tumours situated in the infralabyrinthine and apical compartments of the pyramid and surrounding base of the skull were still a challenge for neurosurgeons and otologists as well. The infratemporal fossa approach closes the existing gap in the surgical management of the most hidden lesions of the temporal bone. The approach features the permanent anterior transposition of the facial nerve, resection of the mandibular condyle and mobilization of the zygoma and lateral orbital rim. Obliteration of the pneumatic spaces of the temporal bone, with permanent occlusion of the Eustachian tube and blind sac closure of the external auditory canal, avoids the danger of post-operative infection and leads to primary wound healing in the shortest time. Three types of infratemporal fossa approach are presented and dicussed on the basis of 51 operated patients.

Adenoma, Chromophobe↗
PubMed1996

Experimental topographic study of high-resolution tympanocochlear scintigraphy using the human temporal bone model.

To determine the diagnostic value of tympanocochlear scintigraphy (TCS), which is still used for the visualization of alterations of labyrinthine bone metabolism due to active otosclerosis, resolution and detection limits were examined in a normal human temporal bone model. After incubation in technetium-99m-labeled diphosphonate solution, scintigraphic imaging showed the zygomatic process and the clivus as landmarks for fine structures of the petrous bone. For further differentiation, labyrinthine fine structures were marked with radioactive tracers of 0.5-1 mm2 each. High-resolution scintigraphic imaging gave two-point discrimination for structures as small as 2.5 mm apart. Localization of the activity patterns was improved by correlating imaging with X-ray photographs or by superimposition with masks of the prepared temporal bones drawn from the X-rays. The correlation of scintigraphic findings with X-ray photographs was found to provide a powerful method for improving the accuracy of localizing temporal bone metabolic changes as it is applicable clinically for studying the occurrence of small active otosclerotic foci.

Aged↗
PubMed1997

Preoperative temporal bone computed tomography scan and its use in evaluating the pediatric cochlear implant candidate.

Preoperative computed tomography (CT) scan evaluation of the temporal bones in cochlear implant candidates plays a crucial role in determining candidacy and the side of implantation. The CT scans allow the surgeon to carefully review the anatomy of the inner ear and mastoid cavity in order to predict any potential difficulties or complications that may be encountered during the implant insertion. We retrospectively reviewed 50 preoperative CT scans of the temporal bone in children who have been successfully implanted. In these scans, we assessed the degree of mastoid pneumatization, cochlear anatomy and patency, size of the vestibular aqueduct, cochlear aqueduct, and internal auditory canal. We analyzed our findings and measurements and compared our results with the degree of difficulty noted in the insertion of the implant, the number of electrodes inserted in each case, and the overall complication rate. From this radiographic review, we have created a checklist for cochlear implant surgeons in order to highlight key features that need to be recognized in the temporal bone scan in preoperative evaluation of cochlear implant candidates.

Adolescent↗
PubMed1990

Fibrous dysplasia of the temporal bone presenting as an osteoma of the external auditory canal.

The involvement of the temporal bones by fibrous dysplasia is uncommon. This disease is usually manifested by a conductive hearing loss. We describe a case of fibrous dysplasia misdiagnosed as an osteoma in a young man. This case emphasizes the need to suspect fibrous dysplasia of the temporal bone as the cause of bony lesions in the external auditory canal in young patients.

Adolescent↗
PubMed1999

Protuberant fibro-osseous lesions of the temporal bone: a unique clinicopathologic diagnosis.

OBJECTIVE: The objective of the study was to describe the clinical presentation and treatment of exophytic fibro-osseous temporal bone lesions, a clinical entity never previously reported, and to consider the differential diagnosis. STUDY DESIGN: The design of the study was a retrospective case review. SETTING: The setting was a tertiary referral center. PATIENTS: Two patients diagnosed with exophytic fibro-osseous temporal bone lesions were included in the study. INTERVENTION: The intervention used was surgical excision. MAIN OUTCOME MEASURE: The main outcome measures were clinical, radiographic, and histopathologic examination. RESULTS: There was no evidence of recurrence at 15 and 17 months after surgery. CONCLUSION: Although fibro-osseous lesions of the temporal bone have been previously reported, there have been no reported cases of an exophytic variant.

Adolescent↗
PubMed1999

An update on the surgical treatment of temporal bone paraganglioma.

In 1982, Fisch described his results for the surgical treatment of 74 paragangliomas of the temporal bone, 5 years after his description of the infratemporal fossa approaches (types A and B). This study reviews the subsequent experience of the Department of Otolaryngology-Head and Neck Surgery of the University of Zürich with more than 136 surgically treated cases of paraganglioma of the temporal bone and discusses our current therapy 20 years after the initial description. One hundred nineteen (90%) of the patients had advanced tumors (Fisch class C or C+D), and 81 (68%) had intracranial extension. Total tumor excision was possible in 109 (82%) patients. Subtotal excision was performed in 22 (17%) patients, 21 of whom had intradural tumor invasion. In these cases, the resection was limited not by actual tumor size but by the degree of intracranial intradural tumor extension. Partial tumor excision was undertaken in only 1 patient with a C4De2Di2 tumor. The success rate in preservation of function of the lower cranial nerves was encouraging. Of the 69 patients whose facial nerve status was followed post-operatively, 81% maintained Fisch grade 76 to 100% (House-Brackman grades I and II). Analysis of follow-up data ranging from 2 to 11 years demonstrated 98% disease-free survival when total tumor extirpation was possible. In the patients who underwent subtotal or partial surgical resection there has been no subsequent tumor growth detected by either clinical or neuroradiological evaluation. We have confirmed after more than 20 years of experience that the infratemporal fossa approaches are a safe, highly effective means of surgical management of paragangliomas of the temporal bone, allowing eradication or arrest of disease with minimal morbidity. Limited intradural surgical resection in cases of very extensive tumors can greatly benefit patients for whom complete excision is not an option.

Journal Article↗
PubMed2004

Destructive, granulating lesion in the temporal bone after elevated plasma homocysteine.

OBJECTIVE: This is a presentation of a seemingly new otolaryngologic disease. SETTING: This study was conducted at a tertiary referral center. CASE REPORT: A 38-year-old healthy man developed left-sided sudden deafness with vertigo and temporary left facial palsy. A granulating and destructive lesion in the left temporal bone was discovered; repeated histologic examination only showed simple granulation tissue. After 6 months, a part of the bony cochlea was extruded. With approximately 8 months' delay and after the patient had had postoperative lung embolism, plasma homocysteine was found to be significantly elevated, a condition known as an independent risk factor for thromboembolic lesions. In the acquired form, it is most often caused by nutritional deficiency of vitamin B cofactors. Accordingly, the patient was treated with folic acid, which rapidly normalized plasma homocysteine. Subsequently, the granulation tissue in the temporal bone gradually disappeared, clinically and radiologically, and the lesion healed, obviously without cochlea function. CONCLUSIONS: Thromboembolic lesion in the left temporal bone, probably in the thin end artery a. labyrintina, i.e., an avascular osteonecrosis. During the latest years, an association between avascular osteonecrosis (most often in the hip) and conditions with increased risk of thrombosis such as hyperhomocystinemia has been established but, to the best of our knowledge, it is never with a lesion in the temporal bone.

Adult↗
PubMed1995

Giant cell tumour of the temporal bone presenting as vertigo.

We report a case of giant cell tumour of the temporal bone arising in a 31-year-old man. The presenting symptoms were unusual, being rotational vertigo, unilateral tinnitus, and hearing loss. A computed tomography (CT) scan showed a large mass within the right temporal bone and the infratemporal fossa. The radiological appearance was suggestive of an aggressive primary neoplasm arising within bone. Biopsy and subsequent resection showed a giant cell tumour of bone. The tumour was histological grade 1. At two-year follow-up, there was no evidence of tumour recurrence or metastasis.

Adult↗
PubMedDate not supplied

Postnatal growth of the human temporal bone. Implications for cochlear implants in children.

Recent interest in cochlear implantation for children has made it important to understand how postnatal growth of the ear will affect such devices. In this study, the postnatal growth of the labyrinth, middle ear, and mastoid was measured in three dimensions using radiographic and temporal bone data. Measurements were made from histologic sections of 48 temporal bones from children and compared to adult temporal bones. Radiographic measurements were made from 253 sets of skull radiographs of children and compared to adult skull series. In the three dimensions measured, there was no postnatal growth of the labyrinth and little variation in size between individuals. Measurements of the middle ear showed greater variation between individuals than measurements of the inner ear, but growth only in the distance from stapes footplate to the tympanic membrane. The mastoid showed growth in all three dimensions: length, width, and depth. The pattern of growth for mastoid length and width appears to follow a double logistic model, with differences between males and females. The growth in mastoid depth is smaller and appears to follow a single exponential curve. The implications for cochlear implantation in children are discussed.

Child↗