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Frequency and localization of congenital anomalies of the middle and inner ears: a human temporal bone histopathological study.

This study investigated congenital anomalies occurring in the middle and the inner ears, with particular attention to their features, localizations, and frequencies. One hundred human temporal bones obtained from 73 individuals, aged 31 gestational weeks to 39 years, each of whom had anomalies of the middle ear and/or inner ear, were used for this study. The temporal bones had been removed at autopsy, fixed, dehydrated, embedded in celloidin, and sectioned horizontally or vertically at 20 microns. Every 10th horizontal section or every 20th vertical section was stained with hematoxylin and eosin, mounted and studied under a light microscope. In the middle ear the structure most often found to be anomalous was the facial nerve; in the inner ear it was the lateral semicircular canal. The implications of the anomalies observed are discussed as they relate to fetal development, dysfunction of the ear, and clinical interpretation of diagnostic radiological studies.

Adolescent↗

ABR and temporal bone pathology in Hurler's disease.

This is believed to be the first report on estimating hearing loss in Hurler's disease, based on the correlation between ABR and temporal bone pathology. ABR findings revealed hearing loss to be about 70 dB or more as result of peripheral mixed impairment. A histological study of the temporal bones revealed almost all pathological findings in the conductive system, except for the hyperplastic arachnoid in the internal auditory canal. In the middle ear cavity, otitis media, residual mesenchyme and deformity of ossicles were found. We explain the conductive component to be due to otitis media and poor ossicular connection. However, the etiology of the sensorineural component remains speculative. In Hurler's disease, hearing loss with mental retardation is often found at infantile age. Therefore, assessing the extent of hearing loss exactly was difficult, for example, the severity. the etiology and incidence of sensorineural impairment. We emphasize the need for not only well-described pathological studies but also for more objective functional investigations, at least ABR.

Child, Preschool↗

Cholesteatomas of the temporal bone: role of computed tomography.

Computed tomography (CT) of the temporal bone was performed in 64 patients thought to have a cholesteatoma of the middle ear. Twenty had not had surgery before, while 44 had been operated on; special consideration was given to 21 patients who were scanned immediately before a second operation and had confirmation of the CT findings. Inflammatory disease without cholesteatoma was characterized by absence of erosion of the otic capsule or ossicular chain. Sharply circumscribed cholesteatomas were easily diagnosed by CT. When they were combined with scarring, granulation tissue, or postsurgical changes, the resulting soft-tissue masses were indistinguishable, although cholesteatoma may be suspected if there is evidence of progressive bone erosion about the middle ear. CT can play a major role in postoperative follow-up by confirming that the ear is normal and demonstrating displacement of ossicular grafts or prostheses.

Cholesteatoma↗

Haemangiosarcoma of the petrous temporal bone.

An unusual case of haemangiosarcoma of the right petrous temporal bone in a nine-year-old male is presented. A conservative surgical approach and a radical course of mega-voltage radiotherapy were employed in the management of the case. At the time of writing, there is no evidence of any recurrence of the tumour.

Child↗

Chondrosarcoma of the temporal bone and otosclerosis.

Chondrosarcoma constitutes 6% of all primary bone tumors and 11% of malignant primary bone tumors. Nevertheless, in a review of the tumor registry of the University of Michigan covering a period of 50 years, there were only 3 cases involving the temporal bone. A case of a woman with a chondrosarcoma of the temporal bone that was partially resected by means of an infratemporal approach at the skull base is presented. This patient had previously undergone surgical treatment for otosclerosis of the other ear. Several considerations regarding survival factors in this type of tumor are dealt with in terms of the histological features, therapeutic options and anatomic location. The possibility that this lesion may originate from the persistence of the cartilaginous inclusions that some authors consider to be involved in the origin of otosclerosis is discussed.

Chondrosarcoma↗

Sex determination by discriminant function analysis of the petrous portion of the temporal bone.

Morphometric variables on the human petrous portion of the temporal bone can provide identification of sex in fragmented skeletal remains. The petrous frequently survives circumstances that cause skeletal fragmentation. Using discriminant function analysis of seven combinations of five variables, up to 74% accuracy can be obtained in determining sex from the petrous portion.

Discriminant Analysis↗

Fibrous dysplasia of the temporal bone.

Fibrous dysplasia is characterized by a progressive replacement of normal bone elements by fibrous tissue. It is seen in the two first decades of life and is equally distributed in relation to the sex of patients. The temporal bone is involved in 18% of the cases. Fibrous dysplasia of the temporal bone is more commonly manifested in the external auditory canal (80%) and the inner and medium ear can also be involved. Sarcomatous alterations are rare. Diagnosis is based on radiological images. Treatment is conservative and surgery is reserved for preserving function and preventing complications. The case of a male patient, 16 years old, who presented with progressive hearing loss over a 1-year period is reported.

Adolescent↗

Benign osteoblastoma of the temporal bone.

We report a case of benign osteoblastoma arising in the temporal bone of a 28-year-old woman. Plain radiography showed a mass with an amorphous calcified matrix and a thin radiolucent marginal zone. CT and MR imaging were useful in delineating the extent of the tumor, and angiography showed its hypervascularity. Preoperative transarterial embolization was effective in reducing bleeding during surgery.

Adult↗

Osteomas of the temporal bone: a report of three cases.

Osteomas of the petrous temporal bone, inaccessible to clinical examination are rare. Three such cases are reported, one in the internal acoustic meatus, one in the middle ear, and the other on the posterior surface of the petrous ridge, emphasizing the role of radiology in their diagnosis evaluation, and as an aid to management.

Adult↗

Bilateral endolymphatic hydrops in Menière's disease: review of temporal bone autopsies.

The wide range in incidence rates reported for bilateral Meniere's disease results mainly from the lack of established clinical criteria for bilaterality, and from follow-ups of varying duration. In order to help determine a reasonable bilateral involvement rate, we examined histologic reports of temporal bones with endolymphatic hydrops. We reviewed the literature on temporal bone autopsies from 1938 to 1988, and selected 72 cases for histologic examination. Of the 72 cases, 67 (93%) showed endolymphatic hydrops, 2 (2.8%) showed collapse, and 3 (4.2%) showed membranous labyrinths of normal appearance. Twenty of the 67 endolymphatic hydrops cases (29.9%) displayed bilateral involvement, suggesting a rate of bilaterality in Meniere's disease of approximately 30%.

Edema↗

Gunshot injury to the temporal bone: an analysis of thirty-five cases.

By retrospective analysis of 35 surviving gunshot injuries to the temporal bone and by presentation of 6 representative cases, the management and reconstructive procedures of these injuries in the Tulane University affiliated hospitals are presented. The most frequent single injury was facial nerve paralysis (16 cases), followed by external canal injury and conductive hearing loss. Anacusis occurred in 12 cases. In conductive hearing loss the intact posterior wall tympanoplasty with mastoidectomy (16 cases), or the modified radical mastoidectomy (5 cases), allowed middle ear reconstruction. Transmastoid facial canal decompression, combined with the above procedures or with a middle fossa craniotomy, was performed in 6 cases. Delayed facial reconstruction (5 cases) utilized microneural anastomosis between facial-facial and hypoglossal-facial nerves and fascia lata slings. Intracranial complications of thrombosis of internal carotid artery, dural venous lacerations, temporal lobe aphasia, bitemporal hemianopsia, cerebral abscesses and meningitis are also discussed.

Adolescent↗

Transverse axial plane anatomy of the temporal bone employing high spatial resolution computed tomography.

Anatomical relationships of temporal bone structures are demonstrated by thin section edge detection computed tomography. Many otic structures are best appreciated in axial view, but reorientation to anatomy as seen in this plane is needed for optimal diagnosis. A level by level review of key structure is presented toward this end. The limitations and advantages of computed tomography are discussed.

Humans↗

Low cost device for removing human and small primate temporal bone plugs.

Previously, only the expensive oscillating saw and Schuknecht temporal trephine were available for removing human temporal bone plugs and no trephines were made for smaller research primates. An inexpensive hole saw has been modified for removing such plugs with an electric drill. This device is less expensive, easier to use, causes less potential impact damage to the plug, and the size of the hole saw can be varied for the size of the skull.

Animals↗

Desmoplastic fibroma of the temporal bone.

A desmoplastic fibroma is a rare entity in the temporal bone. An 86-year-old woman was seen for evaluation of ear discharge and stenosis of the ear canal with a mass involving the post-auricular region. The tumor was found to be a desmoplastic fibroma. The clinical picture, pathology, diagnosis and prognosis of the tumor are discussed.

Aged↗

Temporal bone: comparison of pluridirectional tomography and high resolution computed tomography.

The recent introduction of high resolution computed tomography (CT) capable of resolving delicate bony structures such as the temporal bone marks another significant advance in diagnostic imaging. This study was designed to compare the integrity of these new CT images, standard CT images, and conventional complex motion tomographic images against contact radiographs of sliced anatomic specimens. Temporal bones of three frozen cadaver heads were studied with complex motion tomograms at 1 mm intervals and contiguous CT scans at 1.5 mm intervals in axial, coronal, and sagittal projections. The heads were physically sectioned at 2 mm intervals in planes corresponding to the radiographic planes using a precise indexing and sawing system. The tomographic images were compared for information content to contact radiographs of the anatomic specimen sections. Conventional tomographic images and expanded number range target reconstruction CT images proved to be highly accurate. Standard CT reconstruction images were not. The probable clinical effectiveness of each method is discussed.

Cadaver↗