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PubMed1999

Temporal bone surgery causes reduced nitric oxide synthase activity in the ipsilateral guinea pig hippocampus.

There is a lack of data on the neurochemical basis for the interaction between the vestibular system and the hippocampus. The aim of the present study was to determine levels of nitric oxide synthase (NOS) activity in the ipsilateral and contralateral hippocampi at 10 h following unilateral deafferentation of the peripheral vestibular nerve (UVD) in guinea pig, using a radio-enzymatic technique. The levels of NOS activity were similar in the contralateral hippocampus following either a sham temporal bone operation or the UVD. However, NOS activity was significantly lower in the ipsilateral hippocampus following both the UVD and the sham temporal bone surgery (P<0.05 for both comparisons). These results suggest that even sham temporal bone surgery results in a reduction in NOS activity in the ipsilateral hippocampus.

Animals↗
PubMed1997

Prognostic Factors Including Proliferation Markers Ki-67, bax, and bcl-2 in Temporal Bone Paraganglioma.

Valuable criteria with which to predict the clinical behavior of the temporal bone paraganglioma or the response to treatment are lacking. The analysis of markers of cell proliferation is a possibility to estimate the prognosis. Extensive patient data on 40 temporal bone paragangliomas were gathered over the years and correlated with the data obtained by staining histologic sections with bcl-2, bax, and MIB I markers of cellular proliferation. The immunohistochemistry was in all cases negative for bcl-2, positive for bax, and for Ki-67 positive in 20% of tumors. The scores for Ki-67 did not correlate with the majority of clinical parameters, except for treatment modality, preoperative hearing loss, and cranial nerve involvement. The tendency toward poorer hearing and a higher incidence of preoperative lower cranial nerve palsies was demonstrated in patients with higher Ki-67 scores. Furthermore, the higher rate of subtotal tumor removals in these patients reveals technical difficulties in accomplishing a radical removal, although the incidence of residual tumors was thus not affected. In view of the present information obtained with proliferation markers, the site of tumor origin still remains the most predictive variable for the course of the disease.

Journal Article↗
PubMed1991

Microfissures of the temporal bone: do they have any clinical significance?

Microfissures extending from the inner ear to the middle ear are a common temporal bone finding. Recently they have been implicated as a possible cause of sudden sensorineural hearing loss. We examined 34 temporal bones and related the presence or absence of microfissures to sudden sensorineural hearing loss. No relationship was found.

Collagen↗
PubMed1994

Roller blade falls--a new cause of temporal bone fractures: case reports.

Skating on wheels-in-line skates (roller blading) is an increasingly popular activity. We present two cases of temporal bone fractures from roller blading falls, and review the literature on temporal bone fractures resulting from recreational activities. Since trauma from roller blading may result in significant morbidity, the use of helmets is strongly recommended.

Adult↗
PubMed1985

Eosinophilic granuloma of the temporal bone: simultaneous bilateral involvement.

Although a rare disease, eosinophilic granuloma should be included in the otolaryngologist's differential diagnosis of destructive lesions of the temporal bone. A case of bilateral simultaneous eosinophilic granuloma of the temporal bone is reported. The etiology, incidence, and symptomatology are discussed, as well as the different modalities of treatment as reviewed in the literature.

Child, Preschool↗
PubMed1997

Fibrous dysplasia of the temporal bone: reversal of sensorineural hearing loss after decompression of the internal auditory canal.

When fibrous dysplasia affects the temporal bone, it most often presents with conductive hearing loss attributable to stenosis of the external auditory canal. Sensorineural hearing loss has usually been attributed to involvement of the otic capsule. We present a patient with bilateral fibrous dysplasia of the temporal bones who complained of unilateral hearing loss, facial tingling, and facial twitching. The audiogram showed severe sensorineural hearing loss. The hearing markedly improved and facial twitching and tingling ceased after decompression of the internal auditory canal via a middle fossa approach. This is the only case of which we are aware showing reversal of sensorineural hearing loss caused by fibrous dysplasia.

Adult↗
PubMed1985

Temporal bone fractures: a histopathologic study.

Trauma or injury to the skull, if of sufficient force, may produce a temporal bone fracture. However, terms such as basilar skull fracture, labyrinthine hemorrhage, or labyrinthine concussion are inadequate in that they do not describe the precise histopathologic lesion. We carried out a histopathologic study of the 14 ears in seven patients; all the patients suffered at least one temporal bone fracture. Our objective was to review the histopathologic findings of various fracture lines through the base of the skull and correlate these with the history and clinical findings.

Adult↗
PubMedDate not supplied

Fibrous dysplasia: a review of the disease and its manifestations in the temporal bone.

Fibrous dysplasia is a fairly common, localized misdifferentiation of the bone-forming mesenchyme affecting a single or many bones, in which skeletal aberrations represent the cardinal feature, but in which certain endocrinopathies, abnormal pigmentation of skin and mucous membrane, and occasionally other abnormalities form part of the entire disease process. The craniofacial skeleton is one of its predilective sites and therefore the temporal bone may become involved. In such instances the disease manifests itself with 1) progressive loss of hearing, 2) increasing obliteration of the external ear canal, and 3) enlargement and distortion of the temporal bone. The first part of this communication is concerned with a review of the clinical and pathological aspects of the disease in general. The second part is concerned with a discussion of the clinical manifestations in the temporal bone, based upon analysis of the entire literature and the authors' personal experience. The indications for surgical intervention include 1) maintenance of a normal outer ear canal, 2) preservation of cochlear and vestibular function, and 3) prevention of secondary complications.

Adolescent↗
PubMed1987

The influence of temporal bone anatomical variation upon the caloric stimulus.

This study involved a comparison of temperature changes occurring in isolated cadaveric temporal bones as a result of caloric stimulation, with information gained from radiological examination of the bones by means of high resolution computed tomographic scanning. This was performed in order to investigate the complex nature of heat transfer within the temporal bone and the influence which anatomical variations may have upon the accuracy of evaluation of vestibular function by means of the caloric test. No significant correlation could be found between the maximum temperature change occurring across the lateral semicircular canal and any of the parameters obtained from radiological assessment except for the diameter of the internal auditory meatus. It was deduced that an intra-subject difference in the diameters of the internal auditory meatus of 0.5 mm would introduce an absolute error in the evaluation of percentage canal paresis of 10%. Since normal intra-subject differences in internal meatus diameter can exceed 0.5 mm, this finding was considered to be highly significant.

Caloric Tests↗
PubMedDate not supplied

Benign chondroblastoma of the temporal bone.

Benign chondroblastoma is a rare tumor in the temporal bone. It occurs preponderantly in middle-aged men as a mass in the postero-superior region of the ear canal and is accompanied by hearing loss. On pathologic examination, giant cells and focal regions of chondroid differentiation are noted. After the extent of the tumor has been determined, the treatment is surgical removal. Preoperative irradiation may be helpful. Long-term follow-up is essential.

Adult↗
PubMed1988

Imaging modalities for the study of the temporal bone.

During the past 30 years, rapid and extensive progress has been made in diagnostic imaging of the petrous temporal bone, especially in the techniques of complex motion (pluridirectional) tomography, computed tomography, and magnetic resonance imaging. Because there are a variety of imaging techniques for evaluation of the petrous temporal bone, it is essential to utilize the optimal examinations. Economic factors and the need to reduce unnecessary radiation exposure for the patient are both important considerations.

Ear↗
PubMed1987

Paraganglioma of the temporal bone in infancy. A congenital lesion?

Jugulotympanic glomus tumors have been called many things, but "paraganglioma of the temporal bone" is perhaps a more suitable term. This tumor is generally described as benign with a predilection for middle-aged women. Herein we report the case of an 11-month-old female infant with this condition. The extensiveness of the tumor with intracranial involvement at presentation suggests that the lesion might have been present for some time and raises the question of it being congenital in origin. We emphasize the overall importance of including paraganglioma of the temporal bone in the differential diagnosis of a "bleeding polyp" of the ear.

Female↗
PubMed2000

Magnetic resonance imaging of the normal temporal bone.

Recent advances in magnetic resonance imaging (MRI) technology has allowed the development of imaging sequences tailored to the assessment of exquisite anatomic detail of the temporal bone structures. This article describes MRI of the normal temporal bone anatomy, with emphasis on common anatomic variants and clinically relevant structures.

Ear, Inner↗
PubMed1997

The cochlear aqueduct in pediatric temporal bones.

The cochlear aqueduct is a bony channel which contains the fibrous periotic duct and connects the perilymphatic space of the basal turn of the cochlea with the subarachnoid space of the posterior cranial cavity. Previous histological studies suggested that patency depended on age, whereas a more recent study showed no statistical correlation between age and patency. To clarify patency in pediatric cochlear aqueducts, we selected 21 temporal bones from 12 infants and children, varying in age from birth to 9 years, in which the cochlear aqueduct was fully visible on one histological section. Photographs were taken for documentation and the length and width of the orifice of the external aperture of the aqueduct at the scala tympani were measured and followed to the internal aperture at the subarachnoid space. The lumen of the duct was examined for mononucleated cells, blood cells and fibrous tissue. Measurements revealed that the mean length of the cochlear aqueduct was 4.6 mm (range, 2.4-10.7 mm), mean width of the external aperture was 484 microm (range, 225-869 microm), and mean width of the internal aperture was 1293 microm (range, 699-2344 microm). The mean diameter of the narrowest part (isthmus) was 151 microm (range, 75-244 microm). In all temporal bones the cochlear aqueduct was patent, with one exception. This latter temporal bone was from a 2-month-old girl with multiple intralabyrinthine anomalies, with the missing cochlear aqueduct believed to be due to an aplasia. Our results support prior measurements of the cochlear aqueduct and demonstrate a short and patent cochlear aqueduct in newborns. With growth, a significant increasing length of the duct was found.

Aging↗
PubMed1981

Ossifying fibroma of the head and neck: involvement of the temporal bone- and unusual and challenging site.

Ossifying fibroma of the head and neck is most commonly described in the mandible and maxilla. A few isolated reports in the literature exhibit the rare existence of this lesion in the nasal bones, orbit, ethmoid sinus, sphenoid sinus, occiput, and in only two well-documented cases, the temporal bone. We present the case of an extensive ossifying fibroma of the temporal bone that presented as a suspected case of hyperostosis of the external auditory canal and conductive hearing loss, without any cosmetic deformity. A review of the recent literature concerning the sites, radiologic presentation, difficulty of pathologic differentiation, and modality of therapy is discussed.

Adult↗
PubMed1990

Ossifying hemangioma of the temporal bone.

Intratemporal vascular tumors are more frequent than has previously been noted. Despite their small size, hemangiomas of the temporal bone are extremely aggressive and produce severe neural deficits. The term ossifying hemangioma is used to denote an intratemporal vascular tumor characterized by new bone formation, which is responsible for the typical honeycomb appearance of these tumors on high-resolution computed tomographic scans. Early resection offers the best chance for good facial recovery in patients with vascular tumors of the temporal bone involving the facial nerve. Our case report supports this observation and emphasizes the importance of incorporating these tumors in the differential diagnosis of patients with persistent facial paralysis.

Adult↗
PubMedDate not supplied

Osteogenesis imperfecta of the temporal bone and its relation to otosclerosis.

Osteogenesis imperfecta (OI) designates a heterogeneous group of heritable disorders of connective tissue that in addition to bone may affect tendons, ligaments, fascia, skin, sclerae, blood vessels, teeth, and hearing. The current classification identifies at least four major syndrome groups or types. It also recognizes a considerable number of additional syndromes that may represent supplementary types or subgroups. Loss of hearing is the least constant of the prominent features of OI. Its incidence varies between 26% and 60%. In OI, formation and remodelling of bone are variously affected. In the temporal bone the development of the inner ear capsule may be involved severely. In the stapes the disturbance in lamellar bone formation can lead to extreme thinness, dehiscence, and nonunion of the stapedial superstructure with the footplate. Osteogenesis imperfecta can be associated with otosclerosis, another bone dysplasia with a different morphology. Otosclerosis, in turn, may interfere with sound conduction and perception. Thus, the hearing loss encountered in OI may be the result of OI, otosclerosis, or a combination of both.

Adolescent↗
PubMed1988

Osteoradionecrosis of the temporal bone: a surgical technique of treatment.

Osteoradionecrosis of the temporal bone is a well-documented complication of radiotherapy to the ear, with potentially lethal complications. Three cases of advanced disease, treated surgically, are presented. In two of these, subtotal petrosectomy with blind-sac closure of the external auditory canal was carried out via an anterior approach. The enclosed space was obliterated with pedicled temporalis muscle. Primary healing took place. One case was similarly obliterated using a prolonged posterior incision. The wound broke down, requiring a microvascular free flap for closure. Radiotherapy jeopardizes the viability of skin flaps. An anterior incision bases the flap behind on the occipital and postauricular arteries. When radiotherapy has been used, this incision has theoretical and practical advantages over a standard posterior incision.

Bone Diseases↗