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PubMed1997

Immunohistochemistry of lymphocytes and macrophages in human celloidin-embedded temporal bone sections with acute otitis media.

Immunohistochemical analyses were used to investigate the distribution of lymphocytes and macrophages in routine human temporal bone sections obtained from a subject with acute suppurative otitis media. Primary antibodies specific for human CD3 and CD43 (T-lymphocytes), CD20 (B-lymphocytes), CD45 (leukocyte common antigen), and CD68 (macrophages) were used. As a pretreatment, the sections were soaked in antigen retrieval solution (saturated sodium hydroxide-methanol solution in methanol at a ratio of 1:3). A second antigen retrieval procedure (microwave treatment in 1% zinc sulfate) was also employed for identifying CD3-positive cells. Then the avidin-biotin-peroxidase complex technique was performed. Positive reactions to all antibodies but anti-CD68 were observed in the mucosa of the eustachian tube, tympanic cavity, and mastoid air cells. Particularly, cells positive to anti-CD3 or anti-CD43 were making a diffuse invasion upon the lamina propria. CD68-positive cells were scattered only in the effusion of mastoid air cells. These results suggest that the retrospective immunohistochemical study of archival temporal bone sections is a promising approach to investigate the pathogenesis of otitis media.

Acute Disease↗
PubMedDate not supplied

[Metastatic location in the temporal bone of a primary bladder carcinoma].

The authors on basis of literature point out, the relative shortage in human beings of metastatic locations to the temporal bone from primitive tumours to another seat. After an examination of the anatomopathological report they describe a case, occurred to their observation, of massive metastases to the temporal bone of bladder carcinoma painting out its exceptionality.

Aged↗
PubMed2005

The outcome of radical surgery and postoperative radiotherapy for squamous carcinoma of the temporal bone.

OBJECTIVES/HYPOTHESIS: The objective was to analyze the clinical data and outcome of all the patients treated surgically for squamous carcinoma of the temporal bone in a tertiary referral department of skull base surgery over a 20-year period. STUDY DESIGN: Retrospective. METHODS: Thirty-nine patients with squamous carcinoma of the temporal bone were analyzed. The patients were staged according to the University of Pittsburgh system. The surgical technique, reconstruction of the surgical defect, postoperative radiotherapeutic treatment, follow-up regimen, and results were all described in detail. RESULTS: Disease-free survival for T2N0M0 tumors or stage II disease was 100%. The survival for stage III disease was also 100%. Overall, T3 tumors resulted in 50% survival. Overall, survival for stage IV tumors 34.3%, and for T4 tumors, 38%. CONCLUSION: The overall disease-free survival for the entire series was 43.2%. Node-positive disease, poorly differentiated squamous cell histological findings, brain involvement, and salvage surgery were associated with a poorer outcome. The improved survival (66%) of patients treated de novo in the study series compared with those treated with salvage surgery (33%) suggested that early referral and aggressive primary surgical treatment with postoperative radiotherapy offer the greatest chance of cure.

Adult↗
PubMed1988

Imaging contribution to temporal bone anatomy.

The research programme at the Department of Otoradiology, Uppsala, has been directed towards radio-anatomic investigation of various structures of the temporal bone, such as the jugular fossa, the facial canal, the aqueducts, the internal acoustic meatus, and the extent of pneumatization. Deep-frozen temporal bone specimens have been examined by CT and multidirectional tomography in different projections. After that plastic casts have been prepared. The method allows assessment of the anatomic variations of the structures under study, and also an estimate of the reliability of radiographic reproduction. The resolution capability of CT allows satisfactory reproduction of both inner and middle ear structures. Of the ossicles the malleus and incus with their ligaments are regularly visualized. On rare occasions even the stapes can be reproduced.

Humans↗
PubMedDate not supplied

High grade hemangioendothelioma of the temporal bone in a child: a case report.

Hemangioendothelioma is a rare vascular tumor characterized by endothelial tumor cells and variable malignant behavior, and it's not common for this lesion to involve the bone. Although there are a few reports of cranial involvement by hemangioendothelioma, only rare cases arising in temporal bone have been published. We present the radiologic findings of a 7-year-old boy who had a high grade hemangioendothelioma involving the temporal bone with intracranial extension. Evidence of flow voids on MR images suggested a tumor of vascular origin, and the ill-defined margins, cortical destruction and intracranial extension on the CT and MR images were correlated with the tumor's high histologic grade.

Brain Neoplasms↗
PubMed2001

Definitive radiotherapy in the management of chemodectomas arising in the temporal bone, carotid body, and glomus vagale.

PURPOSE: To evaluate the results of treatment for 71 patients with 80 chemodectomas of the temporal bone, carotid body, or glomus vagale who were treated with radiation therapy (RT) alone (72 tumors in 71 patients) or subtotal resection and RT (8 tumors) at the University of Florida between 1968 and 1998. METHODS AND MATERIALS: Sixty-six lesions were previously untreated, whereas 14 had undergone prior treatment (surgery, 11 lesions; RT, 1 lesion; or both, 2 lesions) and were treated for locally recurrent disease. All three patients who received prior RT had been treated at other institutions. Patients had minimum follow-up times as follows: 2 years, 66 patients (93%); 5 years, 53 patients (75%); 10 years, 37 patients (52%); 15 years, 29 patients (41%); 20 years, 18 patients (25%); 25 years, 12 patients (17%); and 30 years, 4 patients (6%). RESULTS: There were five local recurrences at 2.6 years, 4.6 years, 5.3 years, 8.3 years, and 18.8 years, respectively. Four were in glomus jugulare tumors and one was a carotid body tumor. Two of the four patients with glomus jugulare failures were salvaged, one with stereotactic radiosurgery and one with surgery and postoperative RT at another institution. Two of the five recurrences had been treated previously at other institutions with RT and/or surgery. Treatment for a third recurrence was discontinued, against medical advice, before receiving the prescribed dose. There were, therefore, only 2 failures in 65 previously untreated lesions receiving the prescribed course of RT. The overall crude local control rate for all 80 lesions was 94%, with an ultimate local control rate of 96% after salvage treatment. The incidence of treatment-related complications was low. CONCLUSIONS: Irradiation offers a high probability of tumor control with relatively minimal risks for patients with chemodectomas of the temporal bone and neck. There were no severe treatment complications.

Adult↗
PubMedDate not supplied

Cerebellopontine angle invasive papillary cystadenoma of endolymphatic sac origin with temporal bone involvement.

The authors report the MR, CT, and pathologic findings in a case of invasive papillary cystadenoma originating in the endolymphatic sac and involving the temporal bone. This case illustrates characteristic imaging features of this lesion. The authors emphasize awareness of this entity with its aggressive temporal bone involvement as an aid to pathologic differential diagnosis.

Adenocarcinoma↗
PubMed1977

Surgical anatomy of the temporal bone posterior to the internal auditory canal: an operative approach.

The aim of this study was to describe the anatomical limits of a wedge shaped area of bone lying posterior to the internal auditory canal and to describe the anatomical structures which course through it. One hundred consecutive temporal bones were dissected and topographical dimensions of the posterior wall of the temporal bone were measured along with depth measurements from the posterior fossa wall to the structures of the fundus of the internal auditory canal. A microsurgical technique was then described using the structures within this area as landmarks for specific dissection to the posterior and lateral aspects of the internal auditory canal. Results of 19 tumors have been presented. The status of the facial nerve at the end of surgery and whether or not total tumor removal was possible were discussed.

Arteries↗
PubMed2002

Temporal bone pathology in fetuses exposed to isotretinoin.

Isotretinoin can be teratogenic, affecting many tissues, including the ear. However, there are only two histopathologic studies of the temporal bone in affected humans, and neither describes the findings in early gestation. We had the opportunity to study both temporal bones in each of two fetuses (22 and 24 weeks) exposed to isotretinoin in early gestation. One of the fetuses had a dilated IVth ventricle and a hypoplastic cerebellar vermis, while no dysmorphic features were seen in the other. In both infants the external ears were not noticeably abnormal. Histologically, anomalies of the middle ear included medial deviation of the malleus, forward displacement of the incus, and a small tympanic cavity (4/4); unilateral absence of the stapes (1/4); single "columella" crus and hypoplastic footplate (3/4); and unilateral dehiscence of the facial canal in one infant. Autolysis limited the examination of the labyrinth, but there was reduction in the number of cochlear spirals, and dilatation of the saccule in both infants. Anomalies of the middle and inner ear can be present without anomalies of the external ear or the central nervous system, and may be found even after relatively short exposures. These anomalies are similar to those detected in experimental exposure to isotretinoin, and are consistent with altered expression of the goosecoid gene.

Abnormalities, Drug-Induced↗
PubMed1999

[Temporal bone fracture after head trauma causing rhinoliquorrhea and meningitis].

We report our experience in managing a temporal bone fracture after head trauma that had no apparent clinical signs. Recurrent CSF rhinorrhea and meningitis lead to extensive diagnostic procedures. Operative exploration of the temporal bone demonstrated a fracture line along the horizontal part of the carotid artery. The location of the fracture did not cause such typical symptoms as hearing impairment, facial paralysis, vertigo or tinnitus. Only CSF liquorrhea through the Eustachian tube indicated a fracture at the lateral skull base.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1998

Temporal bone CT findings in the CHARGE association.

Ten out of 20 cases with the CHARGE association and two CHARGE-like cases underwent temporal bone CT scanning and/or MRI: they all showed bilateral aplasia of the semicircular canals and obliteration of the oval windows. Vestibular examination was performed in nine CHARGE cases and the two CHARGE-like cases, which disclosed vestibular areflexia in all of them. Of the 16 evaluable CHARGE cases, eight had bilateral mixed hearing impairment, while eight had sensorineural hearing impairment which was bilateral in six and unilateral in two cases. Temporal bone CT scanning is therefore indicated in suspected CHARGE cases, even if they show normal hearing or a relatively good bone conduction threshold in one or both ears.

Abnormalities, Multiple↗
PubMed1994

Temporal bone dynamics, the hard way. Formation, growth, modeling, repair and quantum type bone remodeling in the otic capsule.

This review presents studies in which temporal bone dynamics were monitored in undecalcified human and animal materials by combined microradiography and osteofluorochromic time labeling. The results are interpreted in accordance with modern concepts of spatial and temporal organization of bone behavior in an attempt to contribute to a new basis for understanding the structure and function of the bony otic capsule. In postcartilaginous development, perilabyrinthine bone formed a separate functional unit in which growth and modeling were absent. Consequently, all drift movements bypassed the bone present inside a narrow perilabyrinthine zone, which in effect maintained a so-called drift barrier enclosing the entire inner ear. In baseline bone remodeling and repair-associated remodeling transients, secondary osteons were distributed centrifugally with respect to inner ear spaces, and the average osteonal size decreased towards the inner ear, suggesting a progressive inhibition of bone resorption towards inner ear spaces. No histological capsular component proved resistant to bone resorption during modeling and remodeling. Instead the dynamic behaviour of any moiety of capsular bone appeared to depend on its spatial relation to the membranous labyrinth rather than on histological characteristics. This spatial organization of perilabyrinthine bone development and turnover is responsible for the unique histology of capsular bone and may explain the accumulation of fatigue micro-cracks which can be found in human perila byrinthine bone. These findings suggests the role of inner ear tissues as a functional matrix in control of capsular bone dynamics even beyond fetal life.

Animals↗
PubMed1986

Pneumatization of the articular eminence of the temporal bone: prevalence, development, and surgical treatment.

Routine panoramic radiographs of 784 patients were evaluated retrospectively for the presence of pneumatization of the articular eminence of the temporal bone (PAT). The radiographs of eight patients showed signs of PAT. These eight patients ranged in age from 32 to 69 years, and four patients had bilateral involvement of the temporal bone. The use of tomography is recommended before surgical procedures involving the eminence to determine the extent of the pneumatization.

Adult↗
PubMedDate not supplied

[Clinical forms of glomus tumors of the temporal bone and base of the skull].

On the basis of the clinical examination of 99 patients, researchers distinguished the clinical forms of the glomus tumour of the temporal bone and of the base of the skull: glomus jugulare tumour, tympanic glomus, glomus of the pyramid of the temporal bone, glomus of the vagus nerve. Every clinical form is characterized both by general symptoms and by signs which appear only with the given form. The peculiarity of the clinical course of glomus tumours is due to intracranial growth, malignization and also by recurrence and prolonged growth.

Abducens Nerve↗
PubMedDate not supplied

The usefulness of MR imaging of the temporal bone in the evaluation of patients with facial and audiovestibular dysfunction.

OBJECTIVE: To evaluate the clinical utility of MR imaging of the temporal bone in patients with facial and audiovestibular dysfunction with particular emphasis on the importance of contrast enhancement. MATERIALS AND METHODS: We retrospectively reviewed the MR images of 179 patients [72 men, 107 women; average age, 44 (range, 1-77) years] who presented with peripheral facial palsy (n=15), audiometrically proven sensorineural hearing loss (n=104), vertigo (n=109), or tinnitus (n=92). Positive MR imaging findings possibly responsible for the patients' clinical manifestations were categorized according to the anatomic sites and presumed etiologies of the lesions. We also assessed the utility of contrast-enhanced MR imaging by analyzing its contribution to the demonstration of lesions which would otherwise not have been apparent. All MR images were interpreted by two neuroradiologists, who reached their conclusions by consensus. RESULTS: MR images demonstrated positive findings, thought to account for the presenting symptoms, in 78 (44%) of 179 patients, including 15 (100%) of 15 with peripheral facial palsy, 43 (41%) of 104 with sensorineural hearing loss, 40 (37%) of 109 with vertigo, and 39 (42%) of 92 with tinnitus. Thirty (38%) of those 78 patients had lesions that could be confidently recognized only at contrast-enhanced MR imaging. CONCLUSION: Even though its use led to positive findings in less than half of these patients, MR imaging of the temporal bone is a useful diagnostic procedure in the evaluation of those with facial and audiovestibular dysfunction. Because it was only at contrast-enhanced MR imaging that a significant number of patients showed positive imaging findings which explained their clinical manifestations, the use of contrast material is highly recommended.

Adult↗
PubMed1989

[The "normal" pneumatization of the temporal bone].

Radiographs of the mastoids and the petrous pyramids of ear-healthy adults were investigated to ascertain the normal appearance of the temporal bone pneumatisation. The radiographs included those of patients with skull trauma, provided that these subjects had had no signs or symptoms of middle ear disease or hearing loss before the trauma. The extent of pneumatisation of the mastoid and petrous pyramid ranged from small cell groups around the mastoid antrum to extensive cell formations in the squamous temporal bone, in the apex of the petrous pyramid and in the retrosinus area. The planimetric measurements did not correspond to a normal distribution. It was also striking that ears could be found among these healthy individuals with irregular, asymmetric or indistinct pneumatisation, probably as a residual of sub-clinical middle ear disorders during the development of the cell system. After eliminating these irregular findings the ears with exclusively regular, symmetric and clear cell pictures also did not follow a normal distribution. Rather, they resulted in a typical curve with a steep ascent rising from a functionally-necessary minimum of about 4 cm2 to mean values of 8-12 cm2, and then a wide distribution reaching a value of 26 cm2. All these can be taken as genetically-determined "normal variants". The irregular cell-formations were seen mainly in the smaller pneumatised mastoids, so that it can be concluded that exogenous influences have at some time disturbed the pneumatisation process.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Effect size on resonance of the outer ear canal by simulation of middle ear lesions using a temporal bone preparation].

By means of a model of the external and the middle ear it is possible to simulate various, exactly defined pathological conditions of the middle ear and to describe their influence on ear canal resonance. Starting point of the investigations are fresh postmortem preparations of 8 human temporal bones with an intact ear drum and a retained skin of the ear canal. The compliance of the middle ear does not significantly differ from the clinical data of probands with healthy ears. After antrotomy it is possible to simulate pathological conditions of the middle ear one after the other at the same temporal bone. The influence of the changed middle ear conditions on ear drum compliance, ear canal volume and on the resonance curve of the external ear canal was investigated. For example, the middle ear was filled with water to create approximately the same conditions as in acute serous otitis media. In this middle ear condition a significant increase of the sound pressure amplification was found, on an average by 4 decibels compared to the unchanged temporal bone model. A small increase in resonance frequency was also measured. The advantages of this model are the approximately physiological conditions and the constant dimensions of the external and middle ear.

Acoustic Impedance Tests↗
PubMed1978

The normal jugular spur, jugular foramen, and jugular bulb as visualized on skull and temporal bone radiographs.

Special jugular foramen views or tomography are generally used to radiographically delineate the jugular spur, jugular fossa, and jugular foramen. Details of this area are not ordinarily searched for by the radiologist on skull films nor otoroentgen views of the temporal bone for various reasons: attention to certain small "key-areas," rectilinear distortion, superimposition of neighboring structures, radiodensity of the petrous pyramid, etc. This paper outlines the radiographic anatomy of the jugular area and details its appearance on plain skull films (AP, PA, and submentovertical projections) and on special views of the temporal bone (Schuller's, Owen's, Mayer's, Stenvers', Low-Beer's).

Humans↗