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PubMed1998

Temporal bone fracture following blunt trauma caused by a flying fish.

Blunt trauma to the temporal region can cause fracture of the skull base, loss of hearing, vestibular symptoms and otorrhoea. The most common causes of blunt trauma to the ear and surrounding area are motor vehicle accidents, violent encounters, and sports-related accidents. We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus.

Adult↗
PubMed2005

[Methods for evaluation of perimodiolar ci electrode arrays in human temporal bones].

BACKGROUND: Cochlear implants (CI) are the established treatment for cochlear deafness. Recently, indications for cochlear implantation have been expanded to include severely hearing-impaired patients. The use of bilateral implants seems to provide additional benefit. Moreover, new electrode designs, i. e. perimodiolar electrode arrays, aim at improving benefit for patients. However, in addition to providing functional improvements, modern electrode array development must also address safety aspects, because damage to the cochlear morphology (especially the osseous spiral lamina) may lead to degeneration of residual neuronal structures and bony obliteration or scarring within the cochlear ducts. METHODS: Therefore, insertion trauma of the newly developed electrode arrays in human temporal bones must be evaluated before applied to patients. Several methods for testing electrode location and intracochlear trauma are described. RESULTS: Combining cross-sectional imaging, histological analysis and elements of risk-assessment valid information about trauma and possible consequences for use in patients can be determined, based on our experience in 57 temporal bones. CONCLUSIONS: Following our results, safety studies with prototype electrode arrays should, in addition to radiological examination, always include careful histomorphological evaluation.

Adult↗
PubMed2006

Flat-panel volume computed tomography for cochlear implant electrode array examination in isolated temporal bone specimens.

HYPOTHESIS: Flat-panel based volume computed tomography could improve cochlear implant electrode evaluation in comparison with multislice computed tomography. BACKGROUND: Flat-panel based volume computed tomography offers higher spatial resolution and less metal artifacts than multislice computed tomography. Both characteristics could improve the evaluation of challenging but important questions in cochlear implantation assessment, such as an exact imaging of cochlea, osseous spiral lamina, electrode array position, and single electrode contacts. These questions are not currently fully answered by multislice computed tomography. METHODS: Four isolated temporal bone specimens were scanned in a current multislice computed tomography scanner and in two experimental flat-panel based volume computed tomography scanners before and after cochlea implantation. To compare flat-panel based volume computed tomography and multislice computed tomography, four features were rated according to the following criteria: 1) visibility of the cochlea; 2) visibility of the osseous spiral lamina; 3) discernibility of individual electrode contacts; and 4) the ability to determine the electrode array position relative to scala tympani and scala vestibuli. Layer-by-layer microgrinding pictures were used as the ground truth for verification of imaging findings. RESULTS: Flat-panel based volume computed tomography was superior to multislice computed tomography in all four features rated. The cochlea and facial nerve canal were much better delineated in flat-panel based volume computed tomography. The osseous spiral lamina and single electrode contacts were only visible in flat-panel based volume computed tomography. Assessment of implant position with regard to the cochlear spaces was considerably improved by flat-panel based volume computed tomography. CONCLUSION: Cochlear implantation assessment could be improved by flat-panel based volume computed tomography and, therefore, would be highly beneficial for cochlea implantation research and for clinical evaluation. However, these first results were shown by scanning isolated temporal bone specimens; scanning whole human skull bases might be more challenging.

Artifacts↗
PubMed1990

Temporal bone pathology of adult-type osteopetrosis.

We present the pathologic features in the temporal bones of a 62-year-old woman with the adult benign form of osteopetrosis. Most of the bony tissue was expanded by dense lamellar bone, with, in some places, the presence of residual calcified cartilage. In the otic capsule, globuli interossei were greatly increased in number. The ossicles were enlarged with fixation of the stapes. Narrowing of mastoid air cells, the internal auditory meati, and eustachian tubes was present, the latter associated with chronic otitis media. The bone deposition in the ossicles contributed to the conductive hearing loss, which was a prominent feature in this patient's otologic findings. The narrowing of the internal auditory meati may similarly have contributed to a degree of sensorineural hearing loss.

Ear Ossicles↗
PubMed1986

The surgical technique for implantation of the temporal bone stimulator (Audiant ABC).

Microsurgical techniques and modern hearing aids are very limited in providing hearing improvement to patients with a vast number of middle ear and external ear canal conditions. A new electromagnetic temporal bone stimulator (TBS), capable of direct stimulation of the cochlea, has been developed. Nothing is placed in the external ear canal. The internal portion of the device is placed in the mastoid portion of the temporal bone, thus completely bypassing the external canal, the ossicles, and the middle ear. This provides stimulation to the inner ear regardless of the condition of the external canal and the middle ear. Unilateral hearing losses may also be benefited by transfer of energy to the opposite ear. Selection of patients, the surgical technique, and the instrumental armamentarium are discussed. The pitfalls and expected results are described.

Audiometry↗
PubMedDate not supplied

Audiological and temporal bone findings in myxedema.

Fifteen patients with confirmed myxedema at a median age of 48 years (range 32 to 60 years) were referred for audiological evaluation before and after treatment with levothyroxine. The median interval between the pretreatment and posttreatment investigations was 18 months (range 9 to 27 months). In addition, 13 patients at a median age of 78 years (range 64 to 95 years) were audiologically reexamined after long-standing levothyroxine treatment. The observation period upon treatment with levothyroxine was 40 months (range 32 to 46 months). No improvement in hearing sensitivity could be demonstrated either in the younger patients or in the elderly. When compared to an age- and sex-matched unscreened population, the myxedematous patients did not demonstrate any different degree of hearing loss. Histological investigation of the temporal bones from an 83-year-old woman with myxedema, however, showed no morphological changes or deposition of glycosaminoglycans, changes which are compatible with true age-related hearing loss. It is concluded that no association exists between myxedema and hearing impairment and that no morphological or structural changes due to myxedema can be demonstrated in the temporal bones.

Adult↗
PubMed1987

Primary adenocarcinoma of the temporal bone mimicking paragangliomas: radiographic and clinical recognition.

Three cases of primary adenocarcinoma of the temporal bone which simulated a glomus jugulare tumor (on the basis of a thorough preoperative evaluation) are detailed. In each case, a vascular mass was seen beneath an intact tympanic membrane and angiography revealed the presence of a highly vascular mass centered on the jugular bulb. Computed tomography revealed erosive changes within the jugular fossa that were characteristic of a glomus jugulare tumor; in two cases, a significant posterior fossa extension was documented. The intraoperative findings failed to suggest a lesion different from paraganglioma in two of the cases; in the remaining case, the erosion of both bone and dura was diffuse and more suggestive of a malignant neoplasm. A discussion of the clinical behavior of adenocarcinomas of the middle ear is included in order to emphasize the importance of differentiating these lesions preoperatively from the more commonly encountered paragangliomas.

Adenocarcinoma, Papillary↗
PubMed2005

Study of a temporal bone of Homo heildelbergensis.

CONCLUSIONS: The characteristic features of the Hh specimen conformed to those of other Pleistocene human fossils, indicating strong cranial structures and a heavy mandible. The mastoid was large and suggested a powerful sternocleidomastoid muscle. The inner ear and tympanic cavities were similar in size and orientation, suggesting that their functions were probably similar. Our observations suggest that the left ear of this Hh specimen was healthy. The large canaliculo-fenestral angle confirms that this ancestor was bipedal. It also strongly suggests that Hh individuals were predisposed to develop certain pathologies of the labyrinth capsule associated with bipedalism, in particular otosclerosis. OBJECTIVE: We studied a temporal bone of Homo heidelbergensis (Hh) in order to investigate the clinical and physiological implications of certain morphological features, especially those associated with the evolutionary reorganization of the inner ear. MATERIAL AND METHODS: The bone, found in a breach of a cave near MAáaga in southern Spain, together with Middle Upper Pleistocene faunal remains, is >300000 years old. Four analytical methods were employed. A 3D high-resolution surface laser scan was used for anatomical measurements. For the sectional analysis of the middle and inner ears of Hh we used high-resolution CT, simultaneously studying a normal temporal bone from Homo sapiens sapiens (Hss). To study the middle and inner ear spaces we used 3D reconstruction CT preceded by an intra-bone air shielding technique. To examine the tympanic cavities and measure the canaliculo fenestral angle, we used a special minimally invasive endoscopic procedure. RESULTS: The surface, sectional and 3D CT examinations showed that the Hh specimen was generally more robust and larger than the Hss specimen. It had a large glenoid fossa. The external meatus was wide and deep. The middle ear, and especially the mastoid, was large and widely pneumatized. There were no appreciable differences in the position and size of the labyrinthine spaces and tympanic cavity. The dimensions of the semicircular canals were similar to those of the Hss specimen. Endoscopy revealed normal, healthy tympanic walls and an ossicle fragment in the atticum that probably belonged to the body of the malleus. The diameters of the fallopian duct and the tympanic opening of the Eustachian tube were large. The canaliculo-fenestral angle was approximately 114 degrees

Animals↗
PubMed1990

[High-resolution CT in evaluation of temporal bone trauma].

High-resolution CT (HRCT) examinations were performed in 22 patients with temporal bone trauma. The CT findings were correlated with the clinical signs and symptoms, routine head CT findings were also examined. HRCT was able to demonstrate fracture lines, ossicular chain disruptions, facial nerve injuries, and hemotympanums in majority of cases. Associated many severe head injuries (brain contusion etc.) were noted in the routine head CT.

Adolescent↗
PubMed1990

Acoustic schwannoma of traumatic origin? A temporal bone study.

A tumour of the singular nerve was found on examination of the temporal bones of a child who died 13 months after meningitis. The tumour consisted of a main mass with the appearance of an acoustic neuroma but close by and not connected were some nests of tumour cells inside the vestibule. This very unusual finding raises questions of the aetiology of this tumour which may have a bearing on the aetiology of other tumours of the VIIIth. nerve.

Cranial Nerve Neoplasms↗
PubMed1990

Three-dimensional images of the temporal bone and experimental otitis media in Japanese monkeys.

Since the middle ear structure of animals commonly used for experimental study is different from that of humans, we used the Japanese monkey (Macaca fuscatus) as an animal model for otitis media with effusion (OME). The exact similarities and differences of the ear structure between humans and Japanese monkeys were studied by the use of computer-aided three-dimensional reconstruction, in addition to light and electron microscopy. Otitis media with effusion was repeatedly induced by direct intratympanic inoculation of one of the following: keyhole limpet hemocyanin; following systemic immunization with keyhole limpet hemocyanin, Streptococcus pneumoniae; or endotoxin. The temporal bones were serially sliced with a diamond band saw, after which the histologic findings were examined by light and electron microscopy on the basis of macroscopic observations. Each substance induced OME equally, 2 to 3 days after inoculation. Inflammatory reaction of the middle ear mucosa extended to all of the air cells; subsequently, the inflamed mucosa returned to normal in each case along with normalization of both the tympanometric and otoscopic findings. No remarkable architectural change remained, even after OME was induced repeatedly. These findings are applicable to acute otitis media and acute mastoiditis. The development of chronic middle ear effusion was not observed in this study. The usefulness of the diamond band saw and computer-aided analysis for temporal bone histologic evaluations is emphasized.

Acute Disease↗
PubMed1993

Megakaryoblastic leukemia presenting as a temporal bone granulocytic sarcoma. Case report.

The unusual presentation of acute megakaryoblastic leukemia as a temporal bone granulocytic sarcoma in an infant without systemic manifestations of leukemia is reviewed. Leukemia should be considered in the differential diagnosis of skull and skull-based lesions since the appearance on neuroradiological imaging is not unique in this diagnosis. Surgical treatment, as in this case, is limited to obtaining tissue for diagnosis and draining the infection.

Child, Preschool↗
PubMed1990

Haemangiopericytoma of the temporal bone.

Haemangiopericytoma is an uncommon vascular tumour with a widespread distribution. Although meningeal involvement is well recognized, only a few sporadic cases of temporal bone lesions have been documented, all with doubtful sites of origin. Late presentation together with the restrictive anatomy of this region often precludes its effective removal and even minimal residual disease may progress rapidly. A series of three such patients are presented in order to discuss the natural history, histological features and treatment of this disease.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of facial nerve paralysis in fractures of the temporal bone].

Of 36 patients with facial nerve palsy caused by the fracture of the temporal bone, 28 were treated surgically and 8 conservatively. The way of treatment was determined after the detailed radiologic, neurootologic, vestibular and functional hearing examinations as well as of the damaged facial nerve. Numerous neurootologic disorders have the decisive clinical value in evaluation of the site and degree of destruction and selection of adequate way of treatment. The authors have shown that early surgical intervention and combined transmastoid and translabyrinthine approach provide the most suitable conditions for surgical management of the facial nerve and all associated damages in the region of the middle and inner ear.

Facial Paralysis↗
PubMedDate not supplied

Endolymphatic hydrops after fenestration: a temporal bone study with implications on the function of the utriculo-endolymphatic valve.

A temporal bone specimen demonstrating endolymphatic hydrops 13 years after fenestration of the lateral semicircular canal is presented. Fibro-osseous tissue extending from the lateral semicircular canal and reaching the vestibule produced fixation of the membranous wall of the utricle to the bony wall. Fixation and retraction of the utricule appears to have resulted in a permanently open utriculo-endolymphatic valve leaflet. Similar findings of fibro-osseous changes arising from the area of the crus commune and an open valve were found in a Meniere's disease specimen. The implications of these findings on the function of the valve are discussed.

Aged↗
PubMed1976

Paget's disease and sensori-neural deafness: temporal bone histopathology of Paget's disease.

Four cases with Paget's disease of the temporal bone are presented to illustrate the pathogenesis of the associated deafness. One case illustrates the combination of severe deafness due to bilateral otosclerosis with probably asymptomatic bilateral Paget's disease. One case with advanced Paget's disease presents features to explain early stages of sensori-neural deafness before actual cellular invasion of the inner ear. One case of profound deafness due to Paget's disease presents a different stage of cellular invasion of the inner ear by the disease on each side. One case illustrates invasion of the internal auditory meatus by Paget's disease with infiltration of the acoustic division of the nerve and profound deafness.

Adult↗