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An unusual image of the temporal bone that is reminiscent of the thumb phalanges is described. This picture is due to an emissary vein in a bilaterally sclerotic mastoid with lateralization of the sigmoid sinus.
When treating cholesteatoma the postoperative tendency, following closed techniques, to develop retraction pockets cannot be influenced by means of a causal therapy. What can be done, however, is to prevent the retraction pocket from becoming a recurrent cholesteatoma. This can be achieved by permanently obliterating the exenterated mastoid cavity with a non resorbable plastic. The bone-cement, Palacos R, we use makes fixed contact with the walls of the operation cavity. Negative effects of such an obliteration have so far not been observed.
A boy 14 years is described who had partial agenesis of the right lateral sinus. Following thrombophlebitis of the left lateral sinus secondary to mastoiditis he developed progressive visual impairment due to papilledema. This was cured by vein graft between the right lateral sinus and the right external jugular vein.
The case of an osteoid osteoma of the right temporal bone (mastoid) in a 21-year-old woman is reported. The suspected diagnosis of osteoid osteoma was based in the retroauricular pain and the findings of the bone scintigraphy and computerized tomography (CT). Histological verification was made after surgical removal of the mass. After a 12-month-follow up, the patient remains asymptomatic.
The use of osseointegrated implants to provide support for auricle prosthesis as been carried out by Tjellstrom. This method has provided the maxillofacial surgeon with another approach to the treatment of defect of the auricle. The principles and concepts of extra-oral osseointegrated implants are the same as those of the intra-oral application developed by Branemark 26 years ago. This simple and reliable method allow the attachment to splint bar fixated to three or two mastoid osseointegrated implants. This method represent an interesting possibility for the management of auricle defects. We report on our experience of 11 cases.
The authors report two cases of eosinophilic granuloma (histiocytosis X) located on the mastoid, position more or less rare and similar to other kinds of pathology. The authors discuss the problems of the nosologic position of "histiocytosis X", the problems of etiopathology, the variety of symptoms and the complications. The many possibilities of therapy (surgical, radiant and chemotherapeutic) will be examined. At the end it's important to locate this pathology in a multidisciplinary management.
The authors report a case of acute mastoiditis in a four year-old boy due to fusobacterium necrophorum. The importance of the complications (septiciemia, lateral sinus thrombosis, meningitis, osteitis) and the fusobacterium necrophorum are the two majors interests of this observation. A review of the literature is performed.
Two primary adenoid cystic carcinomas of the middle ear and mastoid are presented. This pathologic condition is uncommon and no large series exist in the literature. Adenoid cystic carcinoma could arise from ectopic salivary gland tissue located in the wall of the jugular bulb in proximity to the hypotympanum. These tumors demonstrate much invasion of bone and soft tissue. The surgical rationale in the management of this rare tumor is discussed.
This study investigated the effects of down-wall tympanoplasty (open technique included skeletonizing of mastoid) upon external auditory meatus resonance characteristics. The probe tube microphone measurement was performed twice pre and post operatively. The resonance frequency of external auditory meatus remained constant, but the peak amplitude was increased by 0.83dB SPL (P < 0.05). The results indicated that a tympanoplasty with standard open techniques did not affect the normal external auditory meatus resonance characteristics.
OBJECTIVE: To review the occurrence characteristics of and clinical repair experience with brain herniation in to the middle ear and mastoid from 1970-1995. STUDY DESIGN: Retrospective chart/case review. SETTING: Private Otology/Neurotology referral practice. PATIENTS: Thirty-five patients with temporal bone brain herniation diagnosed and treated from 1970-1995. INTERVENTION: Diagnosis confirmed by CT and/or MRI. Treatment was surgical. MAIN OUTCOME MEASURES: Success of surgical repair of the problem in a large experience with follow-up of up to 180 months (mean, 48.7 months). RESULTS: Diagnosis is most effectively made by both (computed tomography (CT) and magnetic resonance imaging (MRI). In this series diagnosis was accurate in 89% with MRI. Primary repair was successful in all but three patients, two of whom required a second repair. One was unreconstructable. CONCLUSIONS: Temporal bone encephaloceles occur after ear surgery and in chronic otitis media. Prompt and effective surgical repair is successful and integral to complication avoidance.
A case of osteogenic sarcoma of the mastoid region of the temporal bone in a 28-year-old male is reported. The rarity of the site is emphasized and the fundamental clinical and therapeutic features are discussed. The literature is reviewed.
A traumatic epidural haematoma, which extended both infra- and supra-tentorially is reported. It also extended into the mastoid antrum and air cell system and was diagnosed by surgical exploration. The radiological findings and treatment are discussed.
Authors have described the case of infected congenital cholesteatoma of the middle ear with congenital atresia of external auditory canal in a 12-year-old child. Congenital aural cholesteatoma was not recognized for aural atresia of external canal and middle ear space. Then mastoid abscess appeared due to infection that arose from nasopharyngs through Eustachian tube to middle ear space. Intraoperatively behind atretic canal closed by atretic plate, in the middle ear space cholesteatoma was found. Surgery for this patient consisted of removing cholesteatoma, canaloplasty and ossiculoplasty. Despite the destruction caused by cholesteatoma and surgical intervention excellent functional results that means hearing improvement were obtained.
A 49-year-old woman had a palpable mass in her occipital region. Plain radiographs and CT examination revealed extensive atlantooccipital pneumatization with findings consistent with the diagnosis of mastoid pneumocele. Decompression was achieved with placement of a myringotomy tube, resulting in prompt symptomatic relief. On a follow-up CT examination, the pneumatized areas had become opacified and new bone formation was present.
Mastoiditis (M) is the most common intratemporal complication of otitis media. The incidence of M has decreased since the advent of antimicrobial agents. In the last decade, however, there has been a marked increased in the incidence of acute M in several communities, sometimes in association with the growing resistance of pneumococci. Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus and Haemophillus influenzae are the most common organisms recovered in acute M. Several recent studies demonstrated the predominance of Pseudomonas aeruginosa in this infection. However, because P. aeruginosa colonizes the ear canal it can contaminate specimens obtained through the non-sterile ear canal. P. aeruginosa, Enterobacteriaceae, S. aureus and anaerobic bacteria are the most common isolates in chronic M. Anaerobes predominate in studies where adequate methods for their isolation are employed. Management of uncomplicated M requires the administration of parenteral antimicrobial therapy and myringotomy with or without tympanostomy tube placement. If no improvement occurs within 48 h, surgical intervention and drainage may be necessary. The procedure generally employed is simple mastoidectomy, and tympanostomy tube placement. Radical mastoidectomy is performed only if there is no improvement after simple mastoidectomy.
Recently, a metric approach to skeletal sex determination was published by Paiva and Segre which is based on the summation of two triangular areas defined by three distinct craniometric landmarks: Porion, Mastoidale, and Asterion. According to the authors, values for the total triangle > or =1447.40 mm(2) are characteristic for male crania, while values < or =1260.36 mm(2) are indicative of female skulls (95% confidence). In order to evaluate the method's validity, two sex- and age-documented samples of different provenience were analyzed (N=197). The results show that while the indicated measurements display significant sex differences, the technique is of little practical meaning where a single individual must be independently classified. It is hypothesized that differences in the expression of sexual dimorphism as well as a population-specific variability of the asterion location undermine the value of the mastoid triangle as a sex determinant.
This study, merging data from two different clinics, was undertaken to evaluate the efficacy of endolymphatic mastoid shunt surgery using the Denver Inner Ear Shunt operation for Meniere's disease. This surgery was performed by the senior authors (C.G.J., J.R.E.D., and M.E.G.) between May 1984 and October 1986, after we attended the Colorado Otologic Research Center (CORC) instructional course. Sixty-six and thirty-four cases, respectively, were performed. Follow-up questionnaires were sent to this total of 100 patients. Fifty-six patients returned completed questionnaires, which formed the basis of this report. A retrospective chart study was also carried out. The results of surgery and questionnaires are reported as statistical data, and, where applicable, the 1985 AAO-HNS criteria for reporting vertigo and hearing results in the treatment of Meniere's disease are used. Preliminary analysis of these data is reported because of its profound effect upon our treatment protocol for patients with Meniere's disease. Results on use of the Denver valve do not appear to be significantly different than the results of other shunt surgery not using the valve.
In 1983, results of a 5-year study using the endolymphatic mastoid shunt for treatment of Menière's disease were reported. Forty-eight patients were followed for between 1 and 5 years postoperatively, and 81% obtained satisfactory relief of vertigo. In the present analysis, 24 of these patients responded to a questionnaire, participated in a direct interview, and completed audiometric evaluations at 7 to 11 years after surgery. Eighty-three percent of these patients reported satisfactory relief of their vertigo. Results for hearing, tinnitus, and limitation of activities also varied little between the initial study and this longer-term follow-up. Studies with shorter follow-up appear valid in predicting longer-term results. These findings support the American Academy of Otolaryngology-Head and Neck Surgery's recommendation of a 2-year follow-up period for reporting results of therapy for Menière's disease.