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PubMed1997

CT screening for temporal bone abnormalities in idiopathic bilateral sensorineural hearing loss.

Bilateral sensorineural hearing loss can be caused by a variety of temporal bone abnormalities including primary cochlear otosclerosis, local and systemic bony diseases and some metabolic conditions. These may be identified using computerized tomography (CT), with attenuation recordings taken across the cochlear capsule (CT densitometry). Eighty patients with bilateral sensorineural hearing loss were screened over a period of six and a half years using this technique, and only three cases (3.8 per cent) of treatable disease were detected. Positive yields may be increased by screening selected cases with other clinical or biochemical stigmata of temporal bone disease.

Absorptiometry, Photon↗
PubMed2005

[Diagnosis of fracture of temporal bone in emergency management-reports of 106 cases].

OBJECTIVE: To summarize the effects of diagnose and therapy the fracture of temporal bone in phase of emergency. METHOD: Retrospectively analyse clinical data of the 106 cases of fracture of temporal bone from 1997 to 2004. Among there are 4 cases were craniotomy, 14 cases were reduction of fracture and 45 cases were debridement suture in the emergency, 6 cases were mastoid-otomy and hemostasis, 3 cases were mastoid exploratory operation and reconstruction of ossicular chain, 1 cases were mastoid exploratory operation and decompression of facial canal, 5 cases were reduction of fracture on external auditory canal. RESULT: Fourteen cases were methospital and antodischarge. 7 cases of facial paralysis are recovered and 2 cases are improved. Descent of audile and vertigo are multirecovery, other are amelioration. CONCLUSION: Diagnoses are based on history of wound and six signs of trauma and the result of CT diagnosis. Critically illed patients are treated according to the principle of "rescue-diagnosis- therapy". Emergency are handling in the sequence: airway were unobstructed, breathing were management, circulatory system were stabilizing, heat preservation, oxygen inhalation and expectant operation. The HRCT were necessary for better instruction therapy with spot of fracture were definition.

Adolescent↗
PubMedDate not supplied

Computerized tomography scanning of the temporal bone.

Computerized tomography (CT) scanning has reached a degree of sophistication that requires alteration of technical factors to demonstrate different parameters of temporal bone pathology. The techniques for pontocerebellar angle display, eustachian tube, middle ear pathology, and overall temporal bone display are quite different. Close cooperation between the radiologist and otologic surgeon are required for optimal use of CT scanning advances.

Adult↗
PubMed1981

Osteopetrosis of the temporal bone.

Osteopetrosis is a rare hereditary disorder of bone development. We examined the right temporal bone of a 17-year-old boy with recessive osteopetrosis and a conductive hearing loss and describe the histopathologic characteristics. The conductive deafness in this case was caused primarily by recurrent otitis media.

Adolescent↗
PubMed1995

The utriculo-endolymphatic valve in pediatric temporal bones.

The utriculo-endolymphatic valve (UEV) is located in the posterior wall of the utricle at its junction with the utricular duct and was first described in a human fetus by Bast in 1928. Although different theories about its normal position and function have been postulated, the function of the UEV remains unclear. In the present investigation we studied 118 temporal bones from 70 children to determine whether there were differences in the position of the valve and by inference, its function between children and adults. Premortem ages ranged from newborn to 10 years (mean age, 11.6 months). All temporal bones were fixed in 10% formalin, decalcified and processed by the celloidin technique. Specimens were sectioned in a horizontal plane at a thickness of 20 microns. Every tenth section was stained with hematoxylin-eosin and studied by light microscopy. The position of the UEV was then classified as closed or open. Valves damaged by preparation or having an uncertain position were classified as artifact. The chi-square test was used to determine a correlation between the position of the valve and the status of the rest of the endolymphatic system and whether or not endolymphatic hydrops was present in the cochlear and vestibular systems. The UEV was closed in 39 temporal bones (33.1%) and open in 13 (11.0%). Artifacts were found in 66 bones (55.9%). In the group of patients with a collapsed ductus reuniens the UEV was closed in 38% of the specimens, suggesting that the UEV prevented loss of endolymph from the pars superior, but these findings were not statistically significant.

Artifacts↗
PubMedDate not supplied

[Temporal bone metastasis of adenocarcinoma of the breast: personal observations and a review of the literature].

A single case of temporal bone metastases from breast carcinoma is reported and its clinical features and main instrumental diagnostic characteristics are described. Although this is quite rare the possibility cannot be neglected when making diagnosis should the clinical features and test results suggest such an expansive process of the temporal bone. In fact, although extremely limited, treatment is strictly linked to proper and early diagnosis.

Breast Neoplasms↗
PubMed1992

Temporal bone histopathology in chronically infected ears with intact and perforated tympanic membranes.

Chronic suppurative otitis media has been clinically defined as a chronic discharge from the middle ear in the presence of a perforation of the tympanic membrane. However, irreversible tissue pathology in the middle ear or mastoid can occur behind an intact tympanic membrane. One hundred forty-four human temporal bones with chronic otitis media were divided into two groups: those with perforated (28) and those with nonperforated (116) tympanic membranes. The histopathological findings of their middle ears were compared. Granulation tissue in various degrees was the most prominent pathological feature. It was observed in 96% of temporal bones with perforation of the tympanic membrane, and in 97% of those without perforation. Also found were ossicular bony changes (96% with perforation; 90.5% without), middle ear effusion (93% with perforation; 89% without), cholesterol granuloma (21% with perforation; 12% without), cholesteatoma (36% with perforation; 4% without), and tympanosclerosis (43% with perforation; 20% without). This study shows that the histopathological changes of the middle ear are similar in temporal bones with and without perforation of the tympanic membrane. The clinician should, therefore, be aware that an intact tympanic membrane does not necessarily preclude the presence of gross pathological changes of the middle ear cleft.

Adolescent↗
PubMedDate not supplied

The temporal bone in patients with Meniere's disease.

Sixty-three patients with Meniere's disease were compared with a group of healthy individuals with respect to findings at tomography and plain radiography. The temporal bone in patients differed in many respects from that in the healthy controls. Characteristic features in patients were a lack of periaqueductal pneumatization, a lack of pneumatization medial to the arcuate eminence, a short vestibular aqueduct, a narrow external aperture of the vestibular aqueduct, and a reduction in size of the mastoid air cell system. The mean mastoid area in the diseased ear in patients was 7.93 cm2 and in controls 11.59 cm2. The vestibular aqueduct was visible in its full length on tomograms in 81% of the healthy controls and in 65% of the diseased ears in patients. The mean volume of the mastoid air cell system in Meniere patients, determined at operation, was 5.3 ml.

Adolescent↗
PubMed1991

A case of eosinophilic granuloma in the temporal bone.

The following case reports a 4-year-old boy with a solitary eosinophilic granuloma in the right temporal bone. The patient complained of an inflammatory tumor in the right external ear canal. The histopathological diagnosis made based on the first specimen of the tumor in the right ear canal was foreign body granuloma. A polyp developed again in the right ear canal with postauricular swelling. Computerized tomography of the skull at that time showed an osteolytic defect in the right temporal bone filled with soft tissue. Diagnosis was established by finding of the presence of Birbeck granules in Langerhans histiocytes by electron microscopy.

Child, Preschool↗
PubMed1999

Management of facial nerve injury due to temporal bone trauma.

OBJECTIVE: This article provides an overview of relevant data regarding the management of facial nerve injury due to temporal bone trauma. DATA SOURCES: Sources used were relevant English language clinical and basic science publications. STUDY SELECTION: A Medline search dating back to 1966 for articles concerning temporal bone trauma and facial nerve injury including both human and animal data was performed. Articles were included if they contained relevant data or were significant reviews on the subject. A retrograde bibliography search was then conducted to acquire any articles that may have been missed by the computerized search, including those papers published prior to 1966. DATA EXTRACTION: The data from each paper were reviewed individually. DATA SYNTHESIS: The data were not amenable to formal meta-analysis or valid data summarization. CONCLUSIONS: Patients who should not require surgical intervention include those who have: documented normal facial nerve function after injury regardless of progression, presentation with incomplete facial nerve paralysis with no progression to complete paralysis, and degeneration <95% on ENoG. The remaining patients presumably have a poorer prognosis for return of facial nerve function although it remains unclear exactly how poor the return of function will be. Decompression surgery likely has a beneficial effect if performed within 14 days of injury, so those patients with expected poor natural outcomes may be offered this intervention. Late decompression surgery is not recommended. Late exploratory surgery is recommended only in those patients who do not experience adequate recovery of facial nerve function and likely require nerve repair. Despite the availability of a relatively large volume of published data, there remain many unanswered questions.

Algorithms↗
PubMed2004

Temporal bone measurements on high-resolution computed tomography.

The distances between the important neural and vascular structures in normal temporal bones were measured by using high-resolution computed tomography (HRCT). We examined 100 normal ears in 50 subjects ranging in age from 15 to 72 years (mean age 39 years). We measured the distances from the medial lip of the posterior wall of the internal auditory canal to the medial wall of the vestibule (mean 9.7 mm), from the cochlea to the tympanic segment of the facial canal (mean 1.76 mm), from the medial wall of the vestibule to the lateral aspect of the lateral semicircular canal (mean 8.03 mm), and from the external auditory canal to the lateral sinus (mean 13.2 mm). HRCT examination is the best method for defining the morphology of temporal bone.

Adolescent↗
PubMed2003

[Eosinophilic granuloma of the temporal bone. Case report and literature review].

BACKGROUND: Eosinophilic granuloma, Hand-Schüller-Christian disease an Letterer-Siwe disease are characterised by ideopathic proliferation of histiocytes producing focal or systemic manifestations. Definitive diagnosis of histiocytosis is made by histopathology including immunohistochemical detection of S-100 and CD1a antigens. In general these diseases are summarised under the term Langerhans-cell histiocytosis (LCH). The localised form of LCH, in which the disease is limited to bones, lymphatic nodes or the lung, is commonly referred to as eosinophilic granuloma. Surgical excision, radiotherapy and chemotherapy, either alone or in combination, are the main treatment options. CASE REPORT: We present the case of a nine-year old boy with an extended eosinophilic granuloma of left temporal bone. The patient was submitted to a chemotherapeutic protocol with glucocorticoids, vinblastine and etoposide. Until today a successful treatment and a complete remission for one year can be reported. CONCLUSIONS: Unifocal eosinophilic granuloma is usually treated by local excision and low-dose irradiation. However treatment with the chemotherapeutic protocol offered an excellent alternative avoiding extensive surgical destruction of the temporal bone in this case.

Biopsy↗
PubMed1995

[Application of digital tomosynthesis to radiographic diagnosis of the temporal bone: studies on visualization in normal subjects].

To examine the usefulness of digital tomosynthesis for conducting radiographic diagnosis of the temporal bone, visualization of various aural structures such as the semicircular canals, cochlea, vestibular apparatus, ossicles of the ear and facial nerve canal was examined in 18 volunteers. The visualization of temporal bone specimens by digital tomosynthesis and CT images (slice thickness: 1.5 mm) was compared. The results showed that this system (Digital Tomosynthesis) produced clear images of bony labyrinthine structures such as the semicircular canals, cochlea, and vestibular apparatus. Visualization of the ossicles was also clear, and their continuity could be comprehended better than on CT images. This system also provided good visualization of the labyrinthine and tympanic parts of the facial nerve canal, although CT images had greater sharpness. Visualization of the lower half of the mastoid part was poor with this system.

Adult↗
PubMedDate not supplied

High-resolution computed tomography of temporal bone: Part III: Axial postoperative anatomy.

The purpose of this 4-part series is to illustrate the nuances of temporal bone anatomy using a high-resolution (200-mu isotropic) prototype volume computed tomography (CT) scanner. The normal anatomy in axial and coronal sections is depicted in the first and second parts. In this and the subsequent part, the structures that are removed and/or altered in 9 different surgical procedures are color coded and inscribed in the same axial (article III) and coronal (article IV) sections. The text stresses clinically important imaging features, including the normal postoperative appearance, and common complications after these operations. The superior resolution of the volume CT images is vital to the comprehensive and accurate representation of these operations. Minuscule intricate structures that are currently only localized in the mind's eye because of the resolution limit of conventional CT are clearly seen on these scans. This enhanced visualization, together with the information presented in the text, should assist in interpreting temporal bone scans, communicating with surgeons, and teaching this complex anatomy.

Humans↗
PubMed2000

Temporal bone findings in multiple endocrine neoplasia type 2B.

To our knowledge, present case is the first published report of temporal bone findings in multiple endocrine neoplasia type 2B (MEN-2B). We describe a 43-year-old Japanese man with medullary thyroid carcinoma (MTC), pheochromocytoma, mucosal neuroma and a Marfanoid body habitus. The collateral adrenal tumors and MTC were removed surgically. However, 14 years after surgery, the MTC and pheochromocytoma recurred and the patient died of intracranial hemorrhage due to hypertension. During the autopsy, metastatic MTC was detected in the liver, lungs, kidneys, pancreas and cervical lymph nodes. Recurrent pheochromocytoma was present in the right kidney. Mucosal neuromas were found in the tongue, gastrointestinal tract and vesical nerve plexus. The following histopathological findings were seen in both temporal bones: metastatic MTC was found as well as neuromas and the cochlear aqueduct was widely patent.

Adult↗
PubMed1989

Inflammatory diseases of the temporal bone: evaluation with CT and MR.

Contrast enhanced CT and MR are complementary studies in evaluating inflammatory disease of the temporal bone. CT should be performed in preference to MR as the initial examination because of its ability to detect and delineate both soft tissue and bony abnormalities. CT should always be performed if intratympanic pathology is suspected, even if the MR examination is normal. MR can be used to distinguish effusion and cholesterol granuloma from other soft tissue masses in the tympanic cavity. Noncontrast MR cannot differentiate between cholesteatoma and granulation tissue. The efficacy of gadolinium-DTPA in inflammatory disease of the temporal bone awaits further investigation.

Cholesteatoma↗
PubMed1989

Granulocytic sarcoma (chloroma) of the temporal bone.

A case of granulocytic sarcoma (chloroma) of the temporal bone in a male child is presented. The diagnosis was confirmed by electron microscopic and histologic findings. The patient presented with otologic and neurological manifestations. CAT scan was at first normal but after some months a mass was apparent in the apex of the petrous bone and a manifestation of preleukemia appeared.

Child, Preschool↗