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At least 1,171 records · Page 65Linked to original sources
PubMed1987

Fibrous dysplasia involving the temporal bone: report of three new cases.

Monostotic fibrous dysplasia, an unusual disease that can involve the temporal bone, will frequently cause an acquired stenosis of the external auditory canal. Three patients with this disorder who presented with occluded canals are described. Two individuals developed external canal cholesteatomas medial to the obstruction, one of whom eventually developed a postauricular abscess and infected draining sinus. The third patient presented with a restenosis nine months following canalplasty. The cases reported illustrate three surgical criteria necessary to manage these unusual cases successfully: removal of sufficient diseased bone to create a patulous canal; resurfacing denuded bony areas with thin split-thickness skin grafts to prevent soft tissue contractions; an adequate meatoplasty. Postoperatively, the reconstructed canals have remained patent and stable during follow-up periods ranging from one to four years. Clinical, radiographic, and pathologic features of fibrous dysplasia are discussed, the differential diagnosis is presented, and the relevant literature is reviewed.

Adolescent↗
PubMedDate not supplied

Obliteration of the mastoid in the treatment of tumors of the temporal bone.

A retrospective analysis of 29 cases of squamous cell carcinoma of the external and middle ear and 15 cases of glomus jugulare tumors of the middle ear was performed to evaluate the incidence of osteoradionecrosis of the temporal bone following surgery and/or radiotherapy. Osteoradionecrosis occurred in 42% (8/19) of cases of squamous cell carcinoma which were treated with radical mastoidectomy, lateral or subtotal temporal bone resection leaving an open cavity and followed by an average of 5,840 rad postoperatively. No osteoradionecrosis, wound breakdown or otorrhea occurred in another group of six patients who were treated by surgical exenteration, total cavity obliteration, and an average of 5,700 rad of postoperative radiotherapy. Thus, cavity obliteration significantly decreased the incidence of these complications (p less than 0.05). In contrast, in 15 patients treated by surgery and postoperative irradiation (average dose = 4,610 rad) for glomus jugulare tumors, no osteoradionecrosis occurred despite use of an open cavity technique.

Adenocarcinoma↗
PubMedDate not supplied

The temporal bone in the preauricular pit, cervical fistula, hearing loss syndrome.

Histological study of the temporal bones of an infant with the preauricular pit, cervical fistula, hearing loss syndrome revealed abnormalities in the middle ear, the vestibular system, and the cochlea. There is a gross bilateral abnormality in the form and relationship of the middle ear spaces, the middle cranial fossa and the inner ear. The horizontal canal lacks ampulla and crista; the posterior canal terminates a short distance from the ampulla. The cochlear cavity is approximately four fifths of normal size. The modiolus of the cochlea shows minor abnormalities. Spiral ganglion cells and peripheral nerve fibers are present in all coils, but are below normal in population in the basal and apical coils. The stria vascularis is slightly deformed and partly atrophic in the upper apical coil. An occasional concretion is present in the base of the stria vascularis in the middle and apical coils.

Adult↗
PubMed1999

Distribution of psammoma bodies in the internal auditory canal and its extended areas in the human temporal bone.

The internal auditory canal (IAC) and its extended areas of 27 normal human temporal bone specimens were investigated histologically for the distribution of psammoma bodies. A total of 145 +/- 25 (mean +/- SE) psammoma bodies were counted in series of every tenth 30-microm-thick section. Psammoma bodies were observed in the IAC and around the labyrinthine portion of the facial nerve (FN), the geniculate ganglion of the FN, and the posterior ampullary nerve in the singular canal. The number of psammoma bodies increases with age. We believe that psammoma bodies are a normal finding of aging in the IAC. The compression of the FN by psammoma bodies in the labyrinthine portion of the facial canal and the distribution of numerous psammoma bodies surrounding the posterior ampullary nerve in the narrow singular canal raise the questions of the involvement of psammoma bodies in the FN and in vestibular dysfunction and the presence of psammoma bodies in the subarachnoid space.

Adolescent↗
PubMed2005

A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. I: Comparison of Nucleus banded and Nucleus Contour electrodes.

In recent years, new designs of cochlear implant electrodes have been introduced in an attempt to improve efficiency and performance by locating stimulation sites closer to spiral ganglion neurons and deeper into the scala tympani. The goal of this study was to document insertion depth, intracochlear position and insertion trauma with the Nucleus Contour electrode and to compare results to those observed with the earlier generation Nucleus banded electrode. For this comparison eight Nuclears banded electrodes and 18 Contour electrodes were implanted in cadaver temporal bones using a realistic surgical exposure. Two experienced cochlear implant surgeons and two otology fellows with specialized training in cochlear implant surgery were selected for the study to represent a range of surgical experience similar to that of surgeons currently performing the procedure throughout the world. Following insertion of the electrodes, specimens were imaged using plain film X-ray, embedded in acrylic resin, cut in radial sections with the electrodes in place, and each cut surface was polished. Insertion depth was measured in digitized X-ray images, and trauma was assessed in each cross-section. The Contour electrode inserted more deeply (mean depth=17.9 mm or 417 degrees ) than the banded electrode (mean depth=15.3 mm or 285 degrees ). The incidence and severity of trauma varied substantially among the temporal bones studied. However, the nature and frequency of injuries observed with the two devices were very similar. The Contour electrode was clearly positioned closer to the modiolus than the banded model, and also appeared easier to use. Based on this difference in position and data from previous studies we conclude that the Contour electrode may provide lower thresholds and improved channel selectivity, but the incidence of trauma remains a problem with the newer design. The relative influences of electrode positioning and neural degeneration that may result from trauma are as yet unclear.

Cadaver↗
PubMed1992

Three-dimensional computer-aided reconstruction and measurement of the temporal bone for singular neurectomy.

A computer reconstruction method was used to study five normal temporal bones for the three-dimensional anatomy necessary for singular neurectomy. The length of the singular canal was 4.9 +/- 0.6 mm. The distal portion of the singular canal courses at a sharp angle (48.2 degrees) to the direction of the transmeatal surgical approach for this operation. The reconstructions indicated that the singular canal can be exposed by introducing a drill through the external auditory meatus at a point 0.71 mm posteroinferior to the posteromedial margin of the round window on the saucerized medial wall of the round window niche. The distance from this site to the distal end-portion of the singular canal averaged 1.47 mm. The point on the drilling course (from the drilling site to the singular canal) closest to the vestibular end of the hook portion of the cochlea was 0.48-1.00 mm from the drilling site. The reconstructions also indicated that the dissection should proceed superomedially, if necessary, after a 1-mm-deep straight dissection along the transmeatal approach. The ampulla of the posterior semicircular canal, cochlear aqueduct and inferior cochlear vein were all found to lie within 2 mm of the drilling point.

Adolescent↗
PubMed1994

A study of neurotransmitters in human inner ear. Preservation of human temporal bone and value of organ donation for inner ear research.

Twenty-nine human temporal bones (TBs) from 3 different groups of patients were used to investigate an effective preservation method of the inner ear and to study the suitability of TBs from organ donors for human inner ear research. Inner ears were fixed by perilymphatic perfusion and immersion fixation. Choline acetyltransferase (ChAT) and gamma-aminobutyric acid (GABA) activities were detected either by an indirect immunostaining method or by the peroxidase-anti-peroxidase (PAP) technique. The results show that the cytoarchitecture of the sensory epithelia is excellently preserved in specimens fixed within 2 h after death. ChAT- and GABA-immunoreactivities were revealed in the efferent nerve endings and fibers of the cochlea. Morphological preservation of the sensory epithelia was also good in specimens fixed within 5 h after death. However, inner ear sensory epithelia of organ donors that had died from head trauma and were in the definite brain death state for at least 7 1/2 h were severely damaged and showed cellular debris due to autolysis, although they were fixed within 2 1/2 h after death. The mechanisms underlying this damage of the sensory epithelia are discussed.

Adult↗
PubMed1976

Secretory otitis media in chronic lymphatic leukaemia. A temporal bone report of a case treated for seven months with tympanostomy tubes.

Serially sectioned temporal bones were studied from a patient with chronic lymphatic leukaemia with submucosal infiltration of the nasopharynx, the resulting secretory otitis having been treated with tympanostomy tubes for 7 months. The initially serous sterile secretion turned mucoid, and a low grade infection supervened. For the last 3 months the tympanostomy tubes were open and the ears dry. In the sections, the mastoid air cells showed leukaemic infiltrations and contained AB- and PAS-positive secretion. The drum openings were without reaction and there was no epithelial ingrowth around the margins. The posterior tympanum in both ears contained organizing fibrous tissue extending from the inner surface of the drum to the promontory. In the tympanum the mucosa was flat or columnar and without glands. Distinct AB and PAS-positive mucus film and secretory cells appeared on the promontory epithelium and the inner surface of the drum. In the tubo-tympanic recess some AB- and PAS-positive subepithelial glands appeared and in the tympanic orifice of the tube the secretory cells were prominent and the lumen full of AB-positive mucus. The case reported represents an intermediate stage in the healing of secretory otitis media, most of the glands having disappeared but the intraepithelial secretory elements being still active.

Aged↗
PubMed2002

Photoacoustic effects of carbon dioxide lasers in stapes surgery: quantification in a temporal bone model.

HYPOTHESIS: The use of the CO2 laser in stapes surgery creates sound waves that could damage hearing. BACKGROUND The application of a laser to any medium has absorption, reflection, and thermal effects. To date, the majority of research on the safety of CO2 laser stapedotomy has focused on the thermal effects of the laser alone. Because of the properties of the CO2 laser, its absorption also presents some risk to the inner ear. This absorbed energy can be converted to photoacoustic or photochemical effects. The goal of this paper is to measure these photoacoustic effects (sounds) produced by the CO2 laser. METHODS: Using a variety of settings, a Sharplan 150 XJ Laser and a Contour model Erbium:YAG laser were applied to the oval window of human temporal bones. Perilymph was simulated by fixing the temporal bone in a normal saline bath. Photoacoustic waves were measured by a hydrophone 2 mm beneath the oval window. Measurements were made with and without a simulated tissue seal over the window. RESULTS: No detectable sounds were created below 4 watts (continuous mode) or 60 mJ (superpulse mode). Above those settings, intensities of 90 dB sound pressure level and higher were detected when the laser was applied directly to the perilymph. With the tissue seal in place, no detectable sounds were identified. The accuracy of this model was confirmed by comparing these results with previously published results using the Erbium:YAG laser. CONCLUSIONS: Below 4 watts in continuous wave mode and below 60 mJ in superpulse mode, any sound generated by the laser is small. Above these thresholds, however, impact sounds are produced that could result in threshold shifts with repeated applications.

Humans↗
PubMed2004

Cystic brain necrosis and temporal bone osteoradionecrosis after radiotherapy and surgery in a patient of ear carcinoma.

Brain cyst formation of temporal lobe induced by radionecrosis in ear carcinoma is rare. A 73-year-old man with basosquamous carcinoma of the left external ear canal received excision of tumor and postoperative radiation therapy in 1992. For osteonecrosis of the left temporal bone, a series treatment including oral and intravenous antibiotics and hyperbaric oxygen therapy was given in following years. Encephalomalasia of the left temporal lobe on brain computed tomography (CT) was noted in 1997. The patient suffered from headache, poor concentration, memory impairment, depressed mood, bad temper, and one 8 x 5 x 3.5 cm cystic lesion of the left temporal lobe with tempomandibular joint defect revealed by brain CT in 2001. Symptoms relieved after stereotactic aspiration of cystic fluid and external drainage (Omaya reservoir) insertion under magnetic resonance image by neurosurgeon. We report the progressive radionecrosis of temporal lobe and cyst formation, which caused the neuropsychological symptoms 10 years after radiotherapy.

Aged↗
PubMed1988

Cerebrospinal otorrhoea--a temporal bone report.

Spontaneous cerebrospinal otorrhoea is a rare complication of a cholesteatoma. The histological findings in a temporal bone from such a case are reported. The cholesteatoma had eroded deeply through the vestibule into the internal auditory meatus.

Aged↗
PubMed2005

A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. II: Comparison of Spiral Clarion and HiFocus II electrodes.

In recent years, several new designs of cochlear implant electrodes have been introduced clinically with the goal of optimizing perimodiolar placement of stimulation sites. Previous studies suggest that perimodiolar electrodes may increase both the efficiency and performance of a cochlear implant. This is the second of two studies designed to examine the positioning of electrodes and the occurrence of insertion-related injury with these newer designs and to directly compare two perimodiolar electrodes to their predecessors. In our previous report we compared the Nucleus banded electrode with the Nucleus Contour perimodiolar electrode. In the present study, using the same protocol, we examine the Spiral Clarion electrode and its successor, the HiFocus II electrode with attached positioner. Eight Spiral Clarion arrays and 20 HiFocus II electrodes with positioners were inserted into human cadaver temporal bones. Following insertion, the specimens were embedded in acrylic resin, cut in quarters with a diamond saw and polished. Insertion depth, proximity to the modiolus and trauma were evaluated in X-ray images and light microscopy. The newer electrode was consistently positioned closer to the modiolus than the previous device whereas the angular depth of insertion measured for the two electrodes was similar. The incidence of trauma was minimal when either electrode was inserted to a depth of less than 400 degrees . However, severe trauma was observed in every case in which the HiFocus II with positioner was inserted beyond 400 degrees and in some cases in which the Spiral Clarion was inserted beyond 400 degrees . To evaluate the possible role of electrode size in the trauma observed we modeled both devices relative to the dimensions of the scala tympani. We found that the fully inserted HiFocus II electrode with positioner was larger than the scala tympani in approximately 70% of temporal bones measured. The results suggest that both the Clarion spiral and HiFocus II with positioner can be inserted with minimal trauma, but in many cases not to the maximum depth allowed by the design.

Cadaver↗
PubMed1991

[Chemodectomas of the temporal bone].

Report of the results of radiotherapy in 12 patients suffering from chemodectomas of the temporal bone. Complete or partial remissions under both clinical and radiological aspects are argued. Discussion on radiotherapy versus surgery of these growths.

Adolescent↗