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PubMed1995

[Secondary tumor of the temporal bone with internal auditory meatus involvement--histopathological study].

Nineteen cases of secondary tumor of the temporal bone with involvement of the internal auditory meatus (IAM) were studied. The cases were classified into 4 invasion modes; direct extension from head and neck tumors (12 cases), hematological dissemination (3 cases), diffuse leptomeningeal carcinomatosis (3 cases), and direct extension of tumors from the intracranium (1 case). There were some differences in the manner in which the tumor had spread among these 4 modes. In most cases involving "direct extension from head and neck tumors", the tumor had invaded the pyramis, and then the Eustachian tube and the middle ear. When the inner ear or the IAM was involved, it was directly invaded by massive tumor. In all cases of "hematological dissemination", metastatic tumor was found bilaterally, but there were some differences in the manner of invasion between the two sides. In "leptomeningeal carcinomatosis" and "intracranial tumor", the tumor had invaded the temporal bone bilaterally via the IAM. In the IAM, cochlear and inferior vestibular nerves were more vulnerable to tumor invasion than facial and superior vestibular nerves. It was suggested that there are some differences in vulnerability to tumor invasion between the superior and inferior vestibular nerves. The bottom of the IAM presented a barrier-like effect against the spread of tumor from the IAM to the labyrinth. In some cases, however, there was massive tumor invasion of the internal ear directly from the IAM. Whether denervation of the ganglionic neurons (spiral or vestibular) causes secondary degeneration of peripheral sensory endorgans remains controversial. In some cases in our series, degeneration of the auditory or vestibular peripheral organs might be attributed to denervation of neurons in the spiral or vestibular ganglia. In other cases, however, auditory and vestibular peripheral organs remained intact despite severe degeneration of ganglionic neurons.

Adolescent↗
PubMed1985

Histopathological features of the spiral ganglion and cochlear nerve in temporal bones from three patients with profound hearing loss.

In the following study the condition of the spiral ganglion and the cochlear nerve of ears from patients suffering from profound hearing loss is described. The number of spiral ganglion cells has been related to the clinical diagnosis. The number of spiral ganglion cells in the two temporal bones of a patient with Neomycin ototoxicity was almost normal. A reduction of less than one-third of spiral ganglion cells has been observed in the temporal bones of a child who died after a bacterial labyrinthitis. The temporal bone with a Mondini dysplasia revealed a pronounced reduction of ganglion cells of more than two-thirds. The cochlear nerve trunk in the internal auditory canal appeared normal in all three cases. The present findings are discussed in respect to the degenerative behaviour of the cochlear neural elements in human being compared to animals.

Aged↗
PubMed1987

Advances in oto-immunology: new trends in functional pathology of the temporal bone.

By using monoclonal and polyclonal antibodies against cell-membrane receptors and cytoskeletal proteins, the cellular and tissue composition of any organ can be far better determined. This is illustrated in the tympanic membrane, middle ear mucosa, and cholesteatoma. Immunotechnology applied to the temporal bone is shown with an animal-ototoxicity model. Antibodies to keratin and vimentin (i.e., to proteins of the fibrillar components that make up the cytoskeleton) stain specific tissue compartments. Langerhans' cell and T-lymphocyte subsets predominate in a cholesteatoma. The normal human tympanic membrane is devoid of these cells. Gentamicin can be traced with a polyvalent anti-gentamicin antiserum in serial sections of the cochlea and kidney. The drug accumulates in the outer hair cells and proximal tubular cells, respectively. A new technique of CT-scanning, microslicing, plastic embedding, and semithin sectioning of undecalcified human temporal bone is described. Perspectives in applying immunotechnology to this method of human temporal bone processing are discussed.

Animals↗
PubMed1992

Anatomy of the guinea pig temporal bone.

The middle ear of guinea pigs has long been used for experimental studies, but no detailed information about its temporal bone anatomy is available. In 18 adult guinea pigs, the temporal bone, eustachian tube, and inner ear anatomy, in addition to the anatomy of the middle ear, were investigated under the dissection microscope. In addition to properties of the eardrum, ossicles, air cell system, and cochlea previously described, the appearance of Huschke's foramen and the crista stapedis in an adult guinea pig ear, the structure of the eustachian tube, the architecture of the internal auditory canal, and the communication of the mastoid cells with the tympanic bulla are described. Differences and similarities among guinea pigs, other experimental animals, and humans are discussed to show the advantages and disadvantages of the guinea pig ear for experimentation.

Animals↗
PubMed1986

An implantable hearing device: osseointegration of a titanium-magnet temporal bone stimulator.

The use of bone conduction hearing devices has recently entered the realm of implantable prostheses and solid-state electronics, resulting in improved fidelity and applicability for a wider range of patients. One particular device, a temporal bone stimulator (TBS), consists of an external sound processor and implanted portion to cause vibration under the skin. An implantable temporal bone stimulator screw constructed of titanium alloy with a permanent magnet can be vibrated by inductive transcutaneous coupling. The safety and osseointegration of the TBS bone screw were tested in adult goats that were free-field stimulated at 75 dB with the TBS processor for 4 to 21 weeks. Histologic comparisons of the soft tissue and bone adjacent to active and passive screws revealed no remarkable differences between them with bone growing in the interstices of the threaded portion. Evidence for mild reorganization of bone was shown with Goldner's stain, which differentiated bone that was young and unmineralized from bone that was older and mineralized. Reorganization was evident in both the active and passive sites and there was no remarkable difference between the two in a blind study. Additional evidence for the integrity of the implant was obtained by subjecting a calvarium containing both screws to a 5000 gauss magnetic field for 10 minutes of a nuclear magnetic resonance head scan. The calvarium was first dissected free from overlying skin and connective tissue. The magnet-containing screws were not loosened. We conclude that the implanted screw portion of the TBS implantable hearing device is well-integrated into the temporal bone. Mild stimulation of new bone growth indicates a healthy long-term viable implant for bone conduction amplification of sound.

Animals↗
PubMed1999

Electron microscopic temporal bone histopathology in experimental pneumococcal meningitis.

Bacterial meningitis is one of the most common causes of acquired profound sensorineural deafness in children. Measurement of hearing and examination of the cochlea is limited in patients suffering from acute meningitis. A rabbit model of pneumococcal meningitis was developed to identify the temporal bone histopathologic changes that occur in meningogenic labyrinthitis caused by Streptococcus pneumoniae. Light microscopy was previously performed on temporal bones from acutely meningitic rabbits with profound hearing loss as determined electrophysiologically. Extensive inflammation of the cochlea with endolymphatic hydrops was observed. The organ of Corti, however, showed preserved architecture in the majority of these animals. In order to further investigate these findings, a protocol was used to create meningitic rabbits with hearing loss ranging from early high-frequency loss to profound deafness. The temporal bones from 7 rabbits were examined by transmission electron microscopy. In cases of mild hearing loss, partial degeneration of the inner row of outer hair cells, as well as edema of efferent cochlear nerve endings and marginal cells of the stria vascularis, was seen. With increasing degrees of hearing loss, the remainder of the organ of Corti and intermediate cells of the stria showed ultrastructural abnormalities. Spiral ganglion cells and basal cells of the stria vascularis remained intact in all subjects. This study provides unique information regarding the histology and pathophysiology of meningogenic deafness. The clinical implications of these findings are discussed, with an emphasis on potentially reversible changes and therapeutic intervention.

Animals↗
PubMed1992

CT-scanning of ancient Greenlandic Inuit temporal bones.

Additional morphological evidence of former infectious middle ear disease (IMED) was found by CT-scanning in 5 of 6 Greenlandic Inuit crania strongly suspected for former IMED due to earlier examination revealing either bilateral hypocellularity or asymmetry of the pneumatized area of the temporal bones. The CT-scans showed sclerosing and obliteration of the air cells and even destruction of the cellular septae, and a high degree of irregularity of the cells. Sclerosing of the surrounding bone tissue was also found. The findings in one cranium were dubious and could both be regarded as a congenital malformation or an infection in infanthood. CT-scan confirms and even adds to the results of conventional X-ray of temporal bones making hypotheses of paleopathology more reliable. The findings also support the environmental theory of pneumatization of the air cell system in the temporal bones.

Air↗
PubMed1996

Developmental anatomy of the supratubal recess in temporal bones from fetuses and children.

The supratubal recess (STR), located superior to the bony eustachian tube and anterior to the attic and often the site of disease, is clearly separated from the attic by the presence of a bony partition. Its anatomic development in childhood, however, remains nuclear. We reviewed serial horizontal sections of fetal and children's temporal bones from the collection of the Otopathology Laboratory, University of Minnesota. Apparently, upward expansion of the bony eustachian tube begins at a late fetal stage and continues throughout childhood, thus forming the STR. Our finding that the STR had already developed in temporal bones without pneumatization of petrous bone suggests that its formation is independent of the air-cell system. Absorption of mesenchymal tissue in the STR tends to be slower than elsewhere in the temporal bone. Surrounded solely by petrous bone, the STR seems, both developmentally and anatomically, a distinctive compartment of the middle ear.

Child↗
PubMedDate not supplied

The influence of perilymphatic pressure on the displacement of the tympanic membrane. A quantitative study on human temporal bones.

A model study on human temporal bones was performed. A microflow method was used in order to assess the possibility of making indirect recordings of changes in the inner ear pressures. Changes in the perilymphatic pressure were recorded as displacements of the tympanic membrane, the stapedius reflex being artificially elicited by forces applied briefly to the stapedius tendon. Changes in the perilymphatic pressures in the range of +/-15 cm H2O affected the position of the tympanic membrane and the "stapedius reflex response". The microflow method used seems suitable for the clinical recording of changes in the intralabyrinthine pressure.

Adult↗
PubMed1993

Otoconia in young and elderly persons: a temporal bone study.

Using serially sectioned human temporal bones, the volumes of otoconia masses were compared between young children and elderly people. The latter group had significantly less otoconia volume than the former group, both in the macula utriculi and macula sacculi. The ratio between macula utriculi and macula sacculi was 100:70 in the young group, whereas it was 100:35 in the elderly group. Thus, the macula sacculi in the elderly group showed the severest otoconia reduction.

Aged↗
PubMed2001

Segmental anatomy of the temporal bone.

More of us suffer from hearing loss than from visual impairment, coronary artery disease, and cancer combined. Auditory dysfunction is detected in less than one third of newborns afflicted and is underdiagnosed in the elderly. Despite biomedical and technological advances, our understanding of vestibular dysfunction has grown little. Forming part of the lateral and inferior surfaces of the skull, the temporal bone contains the organs of hearing and balance. Diagnosis of diseases in these important regions requires adequate clinical information and a thorough knowledge of normal temporal bone anatomy to recognize abnormal findings when present. This article dissects the temporal bone into segments, describes the relevant radiologic anatomy of each, and discusses the imaging appropriate to specific concerns.

Anatomy, Cross-Sectional↗
PubMed1990

Massive ossifying fibroma of the temporal bone.

Ossifying fibromata are rare lesions of the temporal bone. Because the tumors tend to progress and can become clinically massive, early complete resection is advised whenever feasible to prevent clinically evident recurrences and potentially life-threatening complications.

Adult↗
PubMed1991

Ewing's sarcoma of the temporal bone. A case report.

An 11-year-old girl with a primary Ewing's sarcoma in the squamous temporal bone is described, and differential diagnosis and management are discussed. The membranous bones of the skull are rare sites for a primary Ewing's sarcoma; the squamous temporal bone has not been previously described as a primary site.

Child↗
PubMed1987

Irresectable tumours of the temporal bone.

Sporadic case reports and the few published series of expanding lesions of the deep petrous temporal bone propose a variety of surgical approaches to ensure excision. All such surgery represents a compromise between exposure adequate for total removal and avoidance of further neurological deficit. Unfortunately pathology in the petrous apex evolves relatively silently and diagnosis is delayed. In many cases total excision is impossible. We present a series of patients presenting with advanced tumours of the deep petrous temporal bone in order to illustrate the spectrum of disease encountered, the limited role of surgery and the natural history of irresectable pathology in this remote and inaccessible area.

Adult↗
PubMed1987

A histological study of the temporal bones and the nose in Wolf-Hirschhorn syndrome.

We report the histopathological findings of the temporal bones and the nasal and paranasal specimen of a 7-month-old girl diagnosed as having Wolf-Hirschhorn or 4p- syndrome (deletion of the short arm of chromosome 4). This syndrome is characterized by growth retardation, mental retardation, and multiple congenital abnormalities, including craniofacial anomalies and hearing disturbance. These temporal bones displayed malformation of the ossicles, absence of the oval windows, abnormal course of the facial nerve with incomplete bony canal, and depression of the cochlear duct and the saccule. In addition, cholesteatoma, which might be of congenital origin, was present behind the eardrum. The nasal and paranasal specimen showed bilateral complete cleft palate with normal development of paranasal sinuses, nasal septum, and conchae.

Abnormalities, Multiple↗
PubMed2003

Subjective pulsatile tinnitus associated with extensive pneumatization of temporal bone.

Pulsatile tinnitus (PT) although an infrequent otologic symptom. PT can be objective (auscaltable) or subjective (non-auscultable). It has been suggested that subjective PT could occasionally be associated with vascular disorders such as arteriovenous malformation, traumatic or spontaneous carotico-cavernous fistula, intracranial aneurysms, vascular tumors of the temporal bone and cerebellopontine angle, fibromuscular dysplasia, cervical venous hums and high jugular bulb. To our literature knowledge, it has not been reported subjective PT due to extensive pneumatization of temporal bone around internal carotid artery (ICA). In this report, we present a case of subjective PT, which was caused by resonance due to extensive pneumatization of temporal bone particularly peripheral to the ICA.

Aged↗