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A case of rhabdomyosarcoma of the temporal bone in a six-year-old girl is reported. Updated literature and the main therapeutical approaches are reviewed.
BACKGROUND AND PURPOSE: A CT scanner employing a digital flat-panel detector is capable of very high spatial resolution as compared with a multi-section CT (MSCT) scanner. Our purpose was to determine how well a prototypical volume CT (VCT) scanner with a flat-panel detector system defines fine structures in temporal bone. METHODS: Four partially manipulated temporal-bone specimens were imaged by use of a prototypical cone-beam VCT scanner with a flat-panel detector system at an isometric resolution of 150 microm at the isocenter. These specimens were also depicted by state-of-the-art multisection CT (MSCT). Forty-two structures imaged by both scanners were qualitatively assessed and rated, and scores assigned to VCT findings were compared with those of MSCT. RESULTS: Qualitative assessment of anatomic structures, lesions, cochlear implants, and middle-ear hearing aids indicated that image quality was significantly better with VCT (P < .001). Structures near the spatial-resolution limit of MSCT (e.g., bony covering of the tympanic segment of the facial canal, the incudo-stapedial joint, the proximal vestibular aqueduct, the interscalar septum, and the modiolus) had higher contrast and less partial-volume effect with VCT. CONCLUSION: The flat-panel prototype provides better definition of fine osseous structures of temporal bone than that of currently available MSCT scanners. This study provides impetus for further research in increasing spatial resolution beyond that offered by the current state-of-the-art scanners.
The pneumatized articular eminence of the temporal bone is a radiographic finding without clinical signs. Uni- or multi-locular, this radiolucent defect is often unilateral; it affects equally both sexes. The routine use of panoramic radiographs should probably allow a more frequent discovery than before. No treatment is needed. These defects can jeopardize some surgical operations upon the temporomandibular apparatus.
We report a case of a 36-year-old woman who suffered a temporal bone trauma due to a bicycle crash. Computed tomography revealed parapharyngeal emphysema despite only minor temporal bone changes.
Juvenile active ossifying fibroma (JAOF) is a lesion characterized by early age of onset, slow growth, frequent recurrence, and locally aggressive behavior. Histologically, it consists of three major components: cellular fibrous stroma, osteoid bodies, and myxomatous matrix, which may become cystic. This article describes a case of a slowly growing destructive lesion of the mastoid in a 2-year-old girl with histologic features resembling those of juvenile active ossifying myxoma (JAOM). Histologically, its prominent features were myxoid and fibromyxoid stroma with cystic areas, vascular spaces, bone, and multinucleated giant cells. This is the first pediatric temporal bone lesion with these features recorded These histologic components led to the diagnosis of JAOM of the temporal bone, probably developing in relation to the development of the mastoid air spaces.
Temporal bone involvement in Paget disease can result in hearing loss by a variety of mechanisms. One such mechanism is compression of neural structures within the internal auditory canal. This report describes such a case. Magnetic resonance imaging characteristics are discussed, including the appearance of Paget disease following Gd-DTPA administration.
The development and significance of the postglenoid process on the articular surface of the temporal bone were studied using 217 Indian skulls, which were divided by their level of tooth eruption into 6 developmental stages; preeruption period (Stage I), initial stage (m1 eruption) of the deciduous dentition period (Stage II), middle stage (m2 eruption) of the deciduous dentition period (Stage III), late state (eruption of 20 deciduous teeth) of the deciduous dentition period (Stage IV), mixed dentition period (Stage V), and permanent dentition period (Stage VI). Each skull was mounted on a Kraniophor in such a way that the auriculoorbital (Frankfurt) plane was positioned vertical to the horizontal plane and photographed at a focal distance of 40 cm. Using the Frankfurt plane as a base line, the vertical distances to the lowest point of the postglenoid process (a-A), to the deepest point of the mandibular fossa (b-B), and to the mid-point of the articular tubercle (c-C) were measured. The distances from various points of the mandibular fossa to the articular surface of the temporal bone were measured at the level of the Frankfurt plane. The results may be summarized as follows: The length of the postglenoid process as measured from the Frankfurt plane was 0.58 mm at Stage I and 0.75 mm at Stage II. It increased by 0.6-1.0 mm at each developmental stage. By Stage VI, it had increased to 3.85 mm (six- to seven-fold increase from the initial value). The anteroposterior width of the postglenoid process remained almost unchanged throughout the developmental stages. The growth of the articular structures of the temporal bone from the preeruption to deciduous dentition period increased 73% in the total anteroposterior dimension (5.22 mm) and 44% in the total vertical dimension (3.32 mm). The vertical dimension of the mandibular fossa began to rapidly increase following the eruption of the deciduous first molars.
The mastoid air cell system has been recognized as an important contributor to the pathophysiology of middle ear inflammatory diseases. Various methods of temporal bone imaging have been designed to investigate the correlation between middle ear disease and mastoid pneumatization. In this study, the mastoid air cell system was reconstructed three-dimensionally from sagittal tomographic images of the temporal bone on X-ray films, using a personal computer to evaluate the mastoid pneumatization in a total of 29 patients with chronic otitis media, adhesive otitis media, adhesive-type cholesteatoma, attic cholesteatoma and cholesterol granuloma, and in five normal subjects as controls. Reconstructed three-dimensional images of the mastoid air cell system and its volume were analyzed. The reconstructed images were helpful in recognizing the three-dimensional solid appearance of the mastoid air cell system. The volume of the reconstructed mastoid air cell system was significantly reduced compared with that in the controls in each of the patient groups. Mastoid pneumatization in the patients with adhesive-type cholesteatoma was significantly suppressed compared with that in the adhesive otitis media patients. Interestingly, the adhesive otitis media group showed cell development at the tip of mastoid process, whereas the group of adhesive-type cholesteatoma did not, suggesting a difference in the pathophysiology in the two diseases. We found that three-dimensional reconstruction of the temporal bone using sagittal tomographic images was useful in evaluating the state of mastoid air cell system development in individual cases and in investigating the pathophysiology in middle ear disease.
Serial Computed Tomography (CT) scans of isolated temporal bones have been obtained in transverse planes at 1.5 mm intervals. Then gross anatomic sections of same temporal bones were taken at 3 mm. intervals in planes parallel to the CT scans. These CT and anatomic sections were evaluated comparatively.
Giant cell reparative granuloma (GCRG) is an uncommon non-neoplastic lesion that typically occurs in the mandible and maxilla: however, its involvement with the temporal bone is rare. It is usually misdiagnosed as a giant cell tumor. Although regarded as a benign process, GCRG may be locally aggressive. In this paper, we describe two cases of GCRG of the temporal bone and review the pertinent literature published in English. The clinical course, histological evaluation, diagnosis, differential diagnosis, treatment and prognosis of GCRG of the temporal bone were investigated.
The temporal bones of an infant in whom the diagnosis of unblaanced trisomy D (D/D translocation) had been made by chromosomal analysis during life were studied histologically. Most of the findings resembled those that have been described by others in trisomy D (13-15) syndrome. A previously unreported abnoramlity was substrial edema displacing the stria vascularis. The importance of this finding remains to be defined by further study.
The temporal bone appears to be involved with secondary malignant processes in discrete histologic patterns with rather characteristic clinical presentations. Five distinct types of involvement can be recognized: isolated metastasis from a distant primary tumor; direct extension from a regional primary tumor; meningeal carcinomatosis; leptomeningeal extension from an intracranial primary tumor; and leukemic or lymphomatous infiltration. The typical histopathological patterns are described with correlative clinical symtomatology. Differential diagnosis is considered, and guidelines for surgical management are discussed.
The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.
SUMMARY: Hemangioendotheliomas are rare vascular tumors that can affect bone. They account for 0.5% to 1.0% of malignant primary bone tumors. Only four cases have been reported involving the temporal bone. A 5-year-old child with grade II hemangioendothelioma of the right temporal bone is presented, and the radiologic findings on different imaging studies are described. The patient was treated with preoperative endovascular embolization followed by wide surgical resection. The imaging patterns of this malignant tumor may be similar to those of a benign lesion.
OBJECTIVES: Assessment of the long-term results of surgery for temporal bone paragangliomas with special consideration of the patient's ability to cope with the functional deficits. STUDY DESIGN: Retrospective review of 36 patients who had undergone resection of a temporal bone paraganglioma 10 to 15 years previously. Assessment of the patients' subjective view of the functional outcome and quality of life by a questionnaire. METHODS: Clinical records were reviewed regarding size of tumor, technique of surgery, supportive therapy, and tumor recurrence. Patients were sent a 50-item questionnaire evaluating their quality of life and the preoperative and postoperative function of cranial nerves VII through XII. RESULTS: A complete tumor removal was achieved in 30 patients (83%). There was only one tumor recurrence. The major negative effects of surgery involved hearing and dysphagia, which deterioriated in 14 and 12 patients, respectively. Thirty-five of the 36 patients (97%) reported that, despite deterioration, the cranial nerve deficits were still acceptable. Seventy-five percent of the patients regained their preoperative quality of life and 97% returned to their previous occupation in 1 to 2 years. CONCLUSIONS: The otologic extradural approach allowed complete tumor removal in 83%, with minimal perioperative morbidity. No surgically induced central nervous system lesions occured. Tracheostomy was avoided and all patients resumed oral feeding. Full rehabilitation after removal of class C and CD paragangliomas may take 1 to 2 years. However, the fact that 97% of the patients finally resumed normal social life showed the ability of most patients to cope with the sequelae of surgery even in class C and CD paragangliomas.
The authors present a very rare case of concurrent longitudinal and transverse fracture of temporal bones. In this case, both the manifestations as well as the clinical image are quite typical of longitudinal and transverse fractures, the only difference being the lack of posttraumatic paralysis of the facial nerve, which is frequent in the case of transverse fractures. It must be noted that fractures of temporal bones generally occur as the result of road accidents or gunshots, since only a very substantial force may cause the fraction of the cranial basis. Nevertheless, in this case the fracture occurred as the result of an unfortunate fall in the street. The authors did not find any description of a similar case in the available Polish publications.
CT examinations of temporal bones were performed in 31 deaf patients from qualify diagnostic stage prepared for cochlear implants. Essential for surgical treatment anatomic details were estimated, especially canalis spiralis cochleae was paid to attention. In our group, 8 patients had some CT changes (abnormal findings) which corresponded to different stages of obliteration the cochlea. The majority of patients lost the hearing because of meningitis. In 6 implanted patients CT scan was compared with surgical findings. During the operation 1 patient with patent cochlea on CT scan had partially ossified basal turn.
Pathology of the human inner ear has traditionally been studied in celloidin-embedded, hematoxylin and eosin-stained sections of the temporal bone. Although the traditional histologic approach has yielded valuable information, it is now possible to extend these studies to include analysis of molecules using immunohistochemical and histochemical staining techniques. Fourteen antibodies and 6 lectins have been applied to 420 archival, celloidin-embedded human temporal bone sections. Tissues had been fixed in 10% formalin, embedded in celloidin, sectioned, and stored for as many as 40 years. The staining intensities varied among sections, so they were ranked from 'no label" to "dense label." To investigate the relationships between the extent of postmortem changes (PMCs), storage time, and staining intensity for each antibody, the sections were graded according to their PMCs, which ranged from good preservation of the temporal bone histologic structure to severe postmortem autolysis. Although statistical analysis indicated that both extent of PMCs and storage time in general decrease the staining intensity, both poorly fixed tissue and sections stored for a long time can yield good immunostaining results with some antibodies.