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PubMed1988

Differentiation of cartilage and bone in human fetal temporal bones with Luxol fast blue stain.

A modified Luxol fast blue technique was used to study the development of the temporal bone. This staining method makes it possible to make a clear distinction between the primitive cartilage present and the new forming bone. Although these tissues both contain a significant amount of collagen, their staining properties with the Luxol dyes are widely dissimilar, due to the different physicochemical properties of the collagen types involved in these tissues. The differentiation of mesenchymatous tissue into ligaments and joints can also be very clearly demonstrated with this technique. In studying the endochondral ossification process of the otic capsule and middle ear, the modified Luxol fast blue stain is a valuable technique that is complementary to more conventional staining methods.

Cartilage↗
PubMed2001

"Bones of Contention". The donation of temporal bones for dissection after the organ-retention scandals.

It is essential for the Otologist in training to become familiar with the anatomy of the temporal bone. Generations of trainees have acquired this knowledge, together with basic surgical skills and techniques by dissection of cadaver temporal bones. In recent years, however, the supply of temporal bones for dissection has become a contentious issue in many British hospitals. Media and public attention has recently focused on issues surrounding the retention of human tissues following post-mortem examinations. In response, the Chief Medical Officer, the Royal College of Pathologists in the UK, the Faculty of Pathology of the Royal College of Physicians in Ireland, the British Medical Association, and other bodies have issued new guidelines that are of relevance to the Otolaryngologist. This paper gives details of some of the UK guidelines and where they can be accessed. A copy of the Royal College of Pathologists preferred post-mortem consent form is presented. The authors' experience in Manchester is discussed and details of an information leaflet on the subject of temporal bone donation are given. It is concluded that, with knowledge of the existing guidelines and good communication with other hospital colleagues, as well as families of the deceased, it is still possible legally to obtain temporal bones for dissection.

Education, Medical, Graduate↗
PubMedDate not supplied

Anatomic considerations of the medial cuts in the subtotal temporal bone resection.

Eighteen temporal bones, 20 sets of polytomograms, and two sets of histologically sectioned temporal bones were studied and the literature was reviewed in order to describe the evolution and anatomic detail of the medial limits of the subtotal temporal bone resection used when malignant neoplasia has invaded the middle ear. An en bloc resection requires incisions medial to the pneumatized spaces involved. The anatomy of the lines of resection through the glenoid fossa, medial to the lateral wall of the carotid canal, through the cochlea, internal auditory canal, and jugular bulb, and just lateral to cranial nerves IX, X, and XI was described in detail. Regardless of the techniques employed, or the feasibility of the task, the concept of en bloc resection must conform to the anatomy of the region.

Ear Neoplasms↗
PubMed1995

Amplification of mitochondrial DNA from archival temporal bone specimens.

Archival temporal bone collections are an invaluable resource for studying the molecular genetics of many types of otopathology. The irreplaceable nature of temporal bone sections makes efficiency of DNA extraction of paramount importance. Several protocols are available for extracting DNA from fresh and preserved tissue. To establish the best protocol for reliably extracting DNA from celloidin-embedded temporal bone sections, a variety of DNA extraction techniques were tested. Using the optimum protocol, mitochondrial DNA fragments ranging in size from less than 100 base pairs to more than 400 base pairs were amplified, and the authenticity of polymerase chain reaction (PCR) products was confirmed through comparative sequence analysis.

Acetates↗
PubMed1997

Building a virtual reality temporal bone dissection simulator.

The temporal bone is one of seven bones that comprise the human skull, and has an intimate relationship with many vital structures. Anatomically, its three-dimensional relationships make it one of the most challenging areas for surgeons to understand and master. In addition, the temporal bone contains minute structures that are among the most sophisticated and delicate in the human body. These structures include the cochlea and vestibular organs, which are responsible for hearing and balance; the middle ear, including the ossicles, which conduct acoustic energy to the cochlea; and the facial nerve, which is responsible for controlling the muscles of facial expression, and contributes to the sensation of taste. Additionally, the temporal bone forms a major portion of the skull base, and has intimate relationships to vital structures including the carotid artery, jugular vein, cerebral cortex, brainstem, and cranial nerves. Surgical procedures performed on the temporal bone include: procedures to eradicate chronic and acute infections; procedures to remove malignant and benign tumors within the temporal bone, from the skull base, or from the posterior cranial fossa; procedures to restore the hearing mechanism; procedures to eliminate balance disorders; and procedures to correct congenital anomalies. For surgeons-in-training, and even surgeons-in-practice, mastery of the anatomy of the temporal bone and the many complex approaches necessary to treat patients takes years of focused endeavor. This is typically accomplished through the dissection of human cadaver temporal bones, which are scarce, and require a dedicated laboratory facility. Efforts are currently underway to develop a realistic simulator for temporal bone procedures. Users immersed in the simulator will interact with a three-dimensional temporal bone, derived from patient-specific data, using a haptic interface to simulate traditional surgical procedures. Feedback from experts in otologic surgery will be built into the system for additional instruction. This presentation will include an overview of the application being developed, a report of its current state of development, and plans for the future.

Computer Simulation↗
PubMed1980

Aneurysmal bone cyst of the temporal bone presenting as a spontaneous intracerebral hemorrhage: case report.

An aneurysmal bone cyst originating from the squamous portion of the left temporal bone is reported. The lesion presented in a 62-year-old nonhypertensive man as a spontaneous, intraparenchymal left temporal lobe hematoma. No evidence of trauma, hermorrhagic diathesis, or concurrent systemic disease was found. Previous case reports of aneurysmal bone cysts of the skull are reviewed.

Bone Cysts↗
PubMed1988

Histopathology of the facial nerve after longitudinal temporal bone fracture.

The temporal bone histopathology in a patient who suffered repeated head trauma and a longitudinal temporal bone fracture shows unusual features associated with the facial nerve. In the distal meatal segment, a type of traumatic neuroma was found with disorganized nerve bundles and distinct areas of Schwann's cell proliferation but lacking fibrosis. Periosteal new bone formation in the labyrinthine segment narrows the fallopian canal and protrudes into the nerve, which completely fills the canal. The tympanic and mastoid segments of the nerve show severe degeneration of nerve fibers and an increase in connective tissue between fascicles. An attempted facial nerve decompression did not reach the area of primary pathology in the labyrinthine and meatal segments of the nerve, which could have been exposed by the transtemporal supralabyrinthine approach.

Adult↗
PubMed1997

A new alternative to the operating microscope in the temporal bone laboratory.

Cadaveric temporal bone surgery has previously required the use of the operating microscope. However, in this financial climate, the cost of a microscope can prove prohibitive to many departments. We describe a less expensive, alternative form of magnification and illumination in the temporal bone laboratory.

Cadaver↗
PubMed1998

The virtual temporal bone.

The human temporal bone is a 3-dimensionally complex portion of the skull that contains delicate and vital anatomic structures imbedded within dense bone. Current teaching tools have proven to be only marginally adequate for the needs of the aspiring otologic surgeon in learning this anatomy. A variety of image processing and reconstruction techniques were used to reconstruct an anatomically accurate 3-dimensional model of the human temporal bone from serial histologic sections. Using CAVE technology, the model can be manipulated in a stereoscopic virtual environment so that it can be studied from any viewpoint, greatly simplifying the task of learning this anatomy. Applications in surgical planning and Internet based teaching are discussed.

Anatomy↗
PubMedDate not supplied

Osteogenesis imperfecta congenita and tarda: a temporal bone report.

The temporal bone report of an operated case of osteogenesis imperfecta tarda is presented. Histological examination confirmed the presence of bilateral fixation of the footplate by otosclerosis as the cause of the conductive hearing loss. Fragility of bony septae in the mastoid and of the stapedial crura were observed. Sensorineural impairment in later years with a reduction in neural elements in the cochlea appear related to the extent and activity of the otosclerotic foci. Additional temporal bone reports of three cases of osteogenesis imperfecta congenita show lack of deposition of the skein-like bone in the endochondral layer, sparse bony septae in marrow spaces and deficiency of the perosteal layer. The stapedial crura were thin and in two cases both were deformed and fractured.

Aged↗
PubMedDate not supplied

Mucopolysaccharidosis I-H (Hurler's syndrome) and human temporal bone histopathology.

Six temporal bones from three patients with mucopolysaccharidosis I-H are described. All three patients were diagnosed as having mucopolysaccharidosis I-H by enzyme analysis, and all fit the phenotypic criteria of this disease. Family histories of the three cases described were negative for mucopolysaccharide-storage diseases. All three of the patients suffered chronic recurrent otitis media from infancy through death. Common histopathologic findings include otitis media, residual mesenchyme in the round window niche, partial occlusion of the middle ear cavity, and basophilic concretions within the stria vascularis. The common severe histopathologic changes observed in this study and similar findings in the temporal bones described in other studies lead the authors to believe that ear involvement in this disease may be more common than was previously suspected.

Child↗
PubMed1978

Intra and extracranial meningiomas involving the temporal bone.

Meningiomas involving the temporal bone are very rare. Until 1964, only 39 cases had been reported in the world literature. Most series reported are very small and a physician is unable, based on his own experience, to acquire a sufficient knowledge about this entity and may raise serious doubts regarding the diagnosis and management of these tumors. In the past nine years the author has encountered five cases of meningiomas involving the temporal bone. This became a stimulus for a thorough research of the world literature of meningiomas in general, with emphasis on temporal bone involvement. Nine more cases were collected from cooperative physicians with whom the author has been associated. These 14 cases are the clinical material analysed in this study. This thesis is divided into three sections: 1. Exhaustive review of the world literature on meningiomas with emphasis on involvement of the temporal bone. 2. A detailed presentation and discussion of the clinical material stressing the importance of the newer diagnostic methods available and the most modern microsurgical techniques used in otological and neurological surgery procedures, applied to the treatment of those lesions. A light microscopic histopathological study of all cases reported is presented. Electronmicroscopy demonstrates the true intracellular nature of an atypical, recurrent meningioma occurring in a child. 3. A critical evaluation of the cases presented and the value of the diagnostic and therapeutic methods applied in this series of patients are here analysed. Conclusions are then drawn based on the experience and knowledge accumulated in this study. The histopathological diagnosis of meningiomas sometimes is difficult. Probably those tumors involve the temporal bone more commonly than has been reported in the literature. Some of these lesions probably are being misdiagnosed as chemodectomas or other neoplasias. Computerized axial tomography, particularly applied to the diagnosis of brain lesions, is the major break-through of recent modern medicine. A noninvasive technique, when used with contrast enhancement, offers great diagnostic possibilities. Early diagnosis of meningiomas and their complete surgical excision are the key factors necessary for a successful result with a good prognosis and a low recurrence rate. Although these tumors are classically considered radioresistant, radiotherapy may play a role in the treatment of incompletely excised lesions or in patients of a poor surgical risk. Further experiences and time will probably lead to more definite conclusions regarding the role of radiation therapy or the combined surgical and postoperative radiation treatment. Of all brain tumors, meningiomas offer the best prognosis.

Adolescent↗
PubMed1996

Atypical osteomyelitis of the temporal bone.

Osteomyelitis of the temporal bone is a rare disease. The diagnosis and treatment of atypical osteomyelitis of the temporal bone in a 54-year-old woman was reported. The left temporal bone swelling grew slowly from age 9 with only slight deep-seated pain in the temporal area. This condition was assumed to be due to fibrous dysplasia or some benign tumor. It is supposed that exploratory and inadequate mastoidectomies performed on patients age 16 to 19 years might trigger temporal bone osteomyelitis. Extensive surgical debridement followed by antibiotic therapy for 4 weeks yielded good results, and now 2 years after treatment, no signs of recurrence have been observed. The utility of the gallium scan was confirmed for evaluation of disease activity.

Female↗
PubMed1996

Osseointegration and growth effects of temporal bone percutaneous pedestals.

The percutaneous temporal bone pedestal has shown significant utility for the attachment of bone-anchored hearing aids, attachment of cosmetic auricular prostheses, and as connector between external sound processors and implanted cochlear implants. The biological acceptance of these implants by temporal bone hosts is affected by many factors including the maturity of the bone, the design of the pedestal-fixation system, and the pedestal-construction material. The first phase of this study evaluated the effect of the pyrolized graphite pedestal fixation on maturing temporal bones. Pedestals were implanted in young swine temporal bones using single screw and multiple screw fixation systems. The effect on temporal bone growth is demonstrated with photomicrographs and gross photography showing acceptable host-tissue response to the presence of multiple and single screw attachment techniques. Osseointegration of the attaching screws occurred. The second phase of the study evaluated osseointegration of smooth, beaded, and textured titanium pedestals in feline temporal bones. High-resolution temporal bone/pedestal sectioning has been accomplished with high-performance microtomes, showing the osseointegration of the pedestal by the temporal bone. This is demonstrated with tetracycline labeling and histologic assessment. Percutaneous pedestals are of increasing importance in otologic practice. This study assists in the understanding of biologic acceptance of pedestals as influenced by the pedestal composition and fixation design. This basic understanding is essential for design improvements in percutaneous temporal bone pedestals.

Animals↗
PubMed1988

Direct sagittal CT in the evaluation of temporal bone disease.

The human temporal bone is an extremely complex structure. Direct axial and coronal CT sections are quite satisfactory for imaging the anatomy of the temporal bone; however, many relationships of the normal and pathologic anatomic detail of the temporal bone are better seen with direct sagittal CT sections. The sagittal projection is of interest to surgeons, as it has the advantage of following the plane of surgical approach. This article describes the advantages of using direct sagittal sections for studying various diseases of the temporal bone. The CT sections were obtained with the aid of a new head holder added to our GE CT 9800 scanner. The direct sagittal projection was found to be extremely useful for evaluating diseases involving the vertical segment of the facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, external auditory canal, middle ear cavity, infra- and supralabyrinthine air cells, and temporomandibular joint.

Adolescent↗
PubMed1999

Temporal bone meningiomas.

Meningiomas involving the temporal bone may originate from arachnoid cell nests present within the temporal bone (intratemporal), but more frequently originate from arachnoid cell nests of the posterior or middle cranial fossa with secondary invasion of the TB (extratemporal). In this study, we retrospectively reviewed the charts of 13 patients with meningiomas involving the temporal bone who underwent surgery. Tumors of the posterior fossa with only temporal bone hyperostosis, but without invasion, were excluded. Patients presented primarily with otologic symptoms and signs. The tumors originated in the temporal bone (5/13), jugular foramen (4/13), petroclival region (2/13), the asterion (1/13) or the internal auditory meatus (1/13). All of the intratemporal meningiomas had the radiological appearance of en-plaque menigiomas. The tumor extended into the middle ear (11/13), eustachian tube (5/13), and/or the labyrinth (3/13). A gross total resection was achieved in 11 patients and a subtotal resection in 2 patients. The lower cranial nerves were infiltrated by tumor in 4 patients, and were sacrificed. At a mean follow-up of approximately 6 years, 12 patients are currently alive and doing well and 1 died from tumor progression. Six patients showed tumor recurrence and were reoperated on (5/6) or followed conservatively (1/6). Surgical treatment of temporal bone meningiomas is associated with high recurrence rate due to indiscreet tumor margins. Combined surgical approaches (temporal craniotomy and mastoidectomy) by neurosurgical and otological teams are recommended for meningiomas originating in the temporal bone.

Journal Article↗