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PubMed2003

[Temporal bone study of residual mastoid inflammation in ears with normally appearing tympanic membrane].

We examined 395 temporal bones with an intact tympanic membrane to explore the relationship between residual inflammation in the middle ear cavity and development of mastoid pneumatization. Histopathological changes were studied in the middle ear cavity. Mastoid pneumatization was classified as good or poor based on the extent of mastoid tip development to the lateral semicircular canal. Specimens were 344 temporal bones with well-pneumatized mastoid and 51 with poorly-pneumatized mastoid. Otitis media was noted in 119 (34.6%) bones in the good group and 9 (17.6%) in the poor group. In well-pneumatized mastoid, chronic inflammatory changes were frequently observed at the lower portion of mastoid cells, the round window niche, and the tympanic sinus. In contrast, no such incidence of inflammatory change was noted in poorly-pneumatized mastoid. Our findings indicate that an intact tympanic membrane does not always mean freedom from mastoid inflammation, especially when the mastoid is well-pneumatized. This makes it important to check for possible remaining otitis media in patients with a well-pneumatized mastoid, even if the tympanic membrane appears normal.

Ear, Middle↗
PubMed1978

Mycotic infection of the temporal bone.

Herein is a histopathologic study of the temporal bone changes in three patients with fatal systemic fungal infections. All three patients were compromised hosts who failed to respond to adequate chemotherapy. Interestingly, one patient with cryptococcosis had a unilateral hearing loss as the sole manifestation of cerebral cryptococcosis. The most common histopathologic change consisted of a fungal infiltration of the nerves in the internal auditory canal, with moderate infiltration of the sense organs of the membranous labyrinth.

Adult↗
PubMedDate not supplied

Chondroblastoma of the temporal bone: CT and MR appearance.

The authors report a case of chondroblastoma in the unusual location of the temporal bone. CT findings do not differ dramatically from other reports: the lesion appeared as a soft-tissue density mass in the right temporal bone, with bony destruction and thinning of cortical margins. MR findings are more rare: on coronal T1-weighted images the lesion appeared as a mass, isointense to gray matter, centered in the right petrous bone; on axial T2-weighted images, as a mixed-intensity signal mass. They conclude that MR is an accurate indicator of the location and extension of the tumor, but that CT gives more specific information regarding bone involvement.

Chondroblastoma↗
PubMed1987

Quantitative analysis of inner ear anomalies by high resolution CT scanning of the temporal bone.

High resolution CT-scanning of the temporal bone revealed malformations of the labyrinthine capsule in 50 ears in our clinic from November 1980, to the end of 1984. Detailed assessment of the nature and extent of the abnormality allowed each ear to be awarded a mathematical score. Using statistical methods, the score was then correlated with the patient's hearing in that ear. By this method it was possible, with an 80% chance of being correct, to allocate a patient into one of two groups, i.e. partial deafness or total deafness.

Adolescent↗
PubMed1985

Temporal bone fractures. State of the art review.

Advances in technology and otomicrosurgery have dramatically changed the management of temporal bone fractures. Based upon our experiences and a review of the literature, the following recommendations are made: The complete temporal bone surgeon should have access to a late-generation CT scanner and have a good working relationship with a neuroradiologist. The surgeon should be capable of repairing the facial nerve within the internal acoustic meatus, by both middle fossa and translabyrinthine approaches. It is advantageous to follow the progress of cochlear implantation. One should be knowledgeable about the electrophysiologic diagnosis of facial paralysis and know when to be conservative in facial palsy secondary to head trauma.

Adolescent↗
PubMed1980

Histopathological changes in the temporal bone in kwashiorkor.

The histopathological changes in human temporal bones are described for 2 cases of kwashiorkor--a protein/calorie malnutrition (PCM) state. There is photographic evidence of severe damge to the middle and inner ears and to the vestibulocochlear nerve. The middle ear shows evidence of chronic otitis media, a common clinical finding in kwashiorkor. Significantly, the round window membranes in both cases showed thickening and infiltration with inflammatory cells. The inner ear showed the loss of cellular elements and hair cell loss in the spiral organ. A marked decrease of spiral ganglion cells and demyelination of the vestibulocochlear nerve were also seen.

Adolescent↗
PubMed1988

Temporal bone histopathologic findings in drowning victims.

The human temporal bones of five drowning victims, the largest such series, to our knowledge, were evaluated to determine what histopathologic changes occurred. Thickening of the periosteal epithelium, especially on the surgical dome of the otic capsule, was evident in all cases. There was also hemorrhage in the middle ear cavity in four of the cases. In the fifth case, a cholesteatoma and ruptured tympanic membrane were observed, but there was no evidence of hemorrhage. It is proposed that an intact tympanic membrane is needed to create sufficient negative pressure in the middle ear cavity to cause rupture of the blood vessels and hemorrhage. Such bleeding is indicative of drowning when the tympanic membrane is intact.

Aged↗
PubMed1995

Chondrosarcoma of the temporal bone.

Eight patients with a chondrosarcoma of the temporal bone have been treated at the National Hospital for Neurology and Neurosurgery over a 16-year-period. Patients usually presented with symptoms and signs of lower cranial nerve palsies, though in most cases these resolved after surgery. This result, combined with the fact long-term survival can be achieved, makes surgical treatment of these tumours the best option, as the response to primary radiotherapy is uncertain. Surgical access is difficult, but an infratemporal approach is probably the most satisfactory. The use of post-operative adjuvant radiotherapy may provide some benefit. Long-term follow-up is necessary, and for this magnetic resonance imaging (MRI) is preferable to computed tomography (CT) scanning.

Adult↗
PubMed1990

Temporal bone histopathologic findings in Alagille's syndrome.

Six temporal bones obtained from four individuals with Alagille's syndrome, aged 4 months and 3, 6, and 7 years, were studied histopathologically. The external auditory canals and tympanic membranes were normal. Although the stapes, the interossicular joints, and the subarcuate fossae were slightly underdeveloped in the majority of cases, the other structures in the middle ear were almost normal. However, severe anomalies were observed in structures in the inner ear. In all cases, both the bony and membranous structures of the posterior semicircular canal were partially or totally absent, and, in three ears, those of the anterior semicircular canal were also partially absent; the lateral semicircular canal, however, was normal in all cases. The cochlea was observed to be shortened in only one case.

Abnormalities, Multiple↗
PubMed1982

Chemodectomas arising in temporal bone structures.

Eighteen patients with chemodectomas arising in temporal bone structures were evaluated and treated at the University of Florida. Seventeen patients have each been followed a minimum of 3 years. Patients were retrospectively staged as having "local" or "advanced" disease, depending on the presence or absence of bone destruction and/or cranial nerve involvement. Fourteen of the patients received radiation therapy as all or part of their therapy; 6 patients were treated with radiation therapy alone, 3 patients were irradiated immediately postoperatively for residual disease, and 5 patients had radiation therapy for recurrence after operation. They were treated with cobalt-60 radiation with doses ranging from 3760 to 5640 rad. All irradiated patients demonstrated evidence of tumor regression, and none have had tumor recurrence with followup of 3-12 years. Of the 8 patients with cranial nerve paralysis prior to therapy, 5 had return of function of 1 or more cranial nerves. One of 6 patients treated initially with radiation therapy had a complication, while 6 of 8 patients irradiated postoperatively had complications. None of the complications were fatal. Three patients treated by operation for early disease limited to the hypotympanum had the disease controlled for 11-12 years. Guidelines for the selection of initial therapy are discussed.

Humans↗
PubMed2006

Presbycusis: a human temporal bone study of individuals with downward sloping audiometric patterns of hearing loss and review of the literature.

OBJECTIVE: The purpose of this retrospective case review was to identify patterns of cochlear element degeneration in individuals with presbycusis exhibiting downward sloping audiometric patterns of hearing loss and to correlate these findings with those reported in the literature to clarify conflicting concepts regarding the association between hearing loss and morphologic abnormalities. METHODS: Archival human temporal bones from individuals with presbycusis were selected on the basis of strict audiometric criteria for downward-sloping audiometric thresholds. Twenty-one temporal bones that met these criteria were identified and compared with 10 temporal bones from individuals with normal hearing. The stria vascularis volumes, spiral ganglion cell populations, inner hair cells, and outer hair cells were quantitatively evaluated. The relationship between the severity of hearing loss and the degeneration of cochlear elements was analyzed using univariate linear regression models. RESULTS: Outer hair cell loss and ganglion cell loss was observed in all individuals with presbycusis. Inner hair cell loss was observed in 18 of the 21 individuals with presbycusis and stria vascularis loss was observed in 10 of the 21 individuals with presbycusis. The extent of degeneration of all four of the cochlear elements evaluated was highly associated with the severity of hearing loss based on audiometric thresholds at 8,000 Hz and the pure-tone average at 500, 1,000, and 2,000 Hz. The extent of ganglion cell degeneration was associated with the slope of the audiogram. CONCLUSIONS: Individuals with downward-sloping audiometric patterns of presbycusis exhibit degeneration of the stria vascularis, spiral ganglion cells, inner hair cells, and outer hair cells that is associated with the severity of hearing loss. This association has not been previously reported in studies that did not use quantitative methodologies for evaluating the cochlear elements and strict audiometric criteria for selecting cases.

Adult↗
PubMed1999

Temporal bone: comparison of isotropic helical CT and conventional direct axial and coronal CT.

OBJECTIVE: The objective of the study was to compare helical CT (with reformation of coronal images from the axial data set) with conventional direct axial and coronal CT of the temporal bones. SUBJECTS AND METHODS: Nineteen patients underwent both conventional 1-mm direct axial and coronal CT and helical 0.5-mm axial CT. The helical data set was reconstructed at 0.2-mm increments, and axial and coronal images were reconstructed in a plane similar to that of the conventional study, with a slice width of 0.5 mm and 0.5-mm increments. Forty small structures were evaluated independently by three observers, who were unaware of the method of imaging. Observers graded the 40 structures using a modified Likert scale. The graded differences between the two techniques were evaluated using a paired t test. Correlation between observers' gradings was evaluated using analysis of variance. RESULTS: The helical CT technique scored significantly higher than the conventional technique for many individual structures and groups of structures (scutum [p = .041], stapes footplate [p = .006], stapes crura [p = .004], oval window [p = .026], crista falciformis [p = .006], whole temporal bone [P = .012], middle ear [p = .033], inner ear [p = .021], ossicles [p = .044], and stapes [p = .010]). The correlation coefficient among observers was .91 for the whole temporal bone. CONCLUSION: Helical CT using 0.5-mm technique and reconstruction produces diagnostic images comparable with or superior to conventional 1-mm technique because helical CT can obtain thinner slices.

Adolescent↗
PubMed1982

A case of monostotic fibrous dysplasia of the temporal bone associated with epileptic seizure.

An 11-year-old male with monostotic fibrous dysplasia of the left temporal bone was reported. At the age of seven years, the patient began having epileptic attacks, and a bony swelling of the left temporal region was noticed by his mother. Roentgenologically, there were almost thorough osseous obstruction and osseous proliferation of the external auditory canal and pars petrosa, respectively. Audiologic examinations indicated gradual functional disturbance based on the affected internal ear. A total of 20 cases with monostotic fibrous dysplasia of the temporal bone reported between 1946 and 1980 was analyzed, and the association of fibrous dysplasia and epilepsy was discussed.

Child↗
PubMed1988

Jugular bulb position and shape are unrelated to temporal bone pneumatization.

The position and shape of the jugular bulb are undependable, and thus can add difficulty to temporal bone surgery. The present study addresses the hypothesis that position and shape of the jugular bulb correlate with the extent of temporal bone pneumatization. Systematic study was done in 25 unilateral cadaver specimens. Pneumatization was determined using both the classic Runström II radiograph, and computed tomography. Jugular bulb shape and position were determined by anatomic dissection and computed tomography. No association of jugular bulb shape or position, with pneumatization, was found. However, the dissection-determined distance from the plane of the lateral semicircular canal to the roof of the jugular bulb (2 to 15 mm), had a good correlation (r = 0.70, p less than .001) with the distance from the internal auditory canal to the apex of the jugular bulb (1.5 to 15.0 mm).

Humans↗
PubMed1980

Histopathology of Pseudomonas osteomyelitis of the temporal bone starting as malignant external otitis.

Although the natural history and treatment of "malignant external otitis" have been well described, available histopathologic data are limited to three case reports. The histopathology in two additional cases, in which the disease process was advanced and uncontrolled, is presented to illustrate the unique progression of temporal bone osteomyelitis due to the Pseudomonas organism. In both cases the bony labyrinthine capsule demonstrated remarkable resistance to the osteomyelitic process even though the infection seemed to pass around the inner ear from all sides. The most active area of osteomyelitis was at the skull base along the sigmoid sulcus, posterior fossa surface of the temporal bone, and petrous apex. Spread to the opposite petrous apex occurred anterior to the foramen magnum via the basisphenoid, cavernous sinus, and peritubal areas. The clinical and histopathologic data demonstrated that the disease process had a similar progression in both cases, starting in the external auditory canal with spread to the stylomastoid and jugular foramina. This resulted in septic thrombosis of the lateral venous sinus and subsequent extension to the petrous apex from both posterior and middle fossa surfaces of the petrous bone. The infection spread along vascular and fascial planes rather than through pneumatized tracts of the temporal bone. The treatment of this disease is discussed in the light of the histopathologic findings.

Aged↗
PubMed2003

Evaluation of the HiFocus electrode array with positioner in human temporal bones.

The aim of the study presented was to assess the insertion mode and possible intracochlear trauma after implantation of the HiFocus electrode with positioner in human temporal bones. The study was performed in five freshly frozen temporal bones. The position of electrodes was evaluated using conventional X-ray analysis, rotational tomography and histomorphological analysis. Insertion of the HiFocus electrode with positioner resulted in considerable trauma to fine cochlear structures including fracture of the osseous spiral lamina, dislocation of the electrode array from the scala tympani into the scala vestibuli and fracture of the modiolus close to the cochleostomy. The implication of the results regarding clinical outcome will be discussed.

Cochlear Implantation↗
PubMed1995

[Leiomyosarcoma of the temporal bone].

This is a report on a patient of 74 years of age presenting with ear pain and bleeding granulations on his tympanic membrane. X-ray of the mastoid revealed partial destruction of the bone structures and reduced pneumatisation. A tumour that was mainly located in the temporal bone was surgically removed and proved to be a leiomyosarcoma. This is the first case of a leiomyosarcoma of the temporal bone to be described. Differential diagnosis and therapy of this tumour are discussed.

Actins↗