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At least 145 records · Page 8Linked to original sources
PubMed2002

Cancer of the external auditory canal and temporal bone.

Malignant neoplasms involving the temporal bone are a relatively rare and often misdiagnosed disease. Staging of temporal bone cancer has proven difficult because of the small number of patients with this condition, the various histopathologic and histologic findings reported, and a lack of randomized trials. Of the various staging systems that have been proposed, the Pittsburgh classification appears to be the most widely accepted. A retrospective study of 31 patients with temporal bone malignancy at the University of Arkansas for Medical Sciences has led us to propose a modification of the Pittsburgh classification for early-stage lesions. This modification places more emphasis on the site of disease in the canal and less on the size of the primary tumor or degree of bony invasion. This review discusses this staging system, the management of these tumors in a multidisciplinary team approach, reconstructive options, and auditory rehabilitation.

Clinical Trials as Topic↗
PubMedDate not supplied

Normal and metastatic melanin in the temporal bone.

PURPOSE: Malignant melanoma is known to metastasize to the temporal bone. However, melanocytes exist in the normal inner ear and may be difficult to distinguish from metastatic melanotic cells. This study describes distribution of normal melanin in the ear and metastatic melanoma to the temporal bone. MATERIALS AND METHODS: Normal melanin distribution is described in 48 temporal bones from White (18), Native-American (19), and African-American (11) individuals and metastatic melanoma to the temporal bone is described in four cases (seven temporal bones). Temporal bones were removed at autopsy, fixed in 10% buffered formalin, and processed for routine celloidin embedding. Sections were cut at a thickness of 20 microns and every tenth section was stained with hematoxylin-eosin for light microscopic evaluation. RESULTS: Normal melanin was found in the inner ear, mainly around terminal neural structures and blood vessels, and occurred in greater quantities in African-American individuals. Metastatic melanotic cells reached the temporal bone by hematological dissemination, and by neural invasion from the central nervous system. No correlation was found between histopathological findings and clinical symptoms of patients. CONCLUSIONS: Metastatic melanoma to the temporal bone may be seen in the same areas as normal melanin. They may also be observed in bone marrow cells of the petrous bone and along the course of nerves of the internal auditory canal and cochlear vestibular labyrinth, either by following neural sheaths or blood vessels that run along the nerve. Metastatic disease to the temporal bone is often asymptomatic, or it may present with uncharacteristic symptoms that may delay diagnosis.

Adult↗
PubMed1979

Temporal bone trauma and facial paralysis.

Temporal bone trauma includes a wide range of injuries of greater and lesser severity, most of which require the immediate attention of an otolaryngologist. The most common temporal bone injuries encountered in an emergency room setting include longitudinal and transverse fractures of the temporal bone with and without facial paralysis, labyrinthine concussion, foreign bodies in the external canal, penetrating injuries via the external auditory canal, and pressure injuries, including otitic barotrauma, water skiing accidents, blows or slaps to the ear or side of the head, and severe impact noise. A brief but inclusive examination can be performed within the limitations necessarily imposed by an emergency room setting. Cranial nerve screening, balance testing, hearing, and vestibular evaluation can be accomplished with a considerable degree of accuracy. To a large extent, the long term result reflects the quality of the initial examination.

Barotrauma↗
PubMed2003

[Computed tomography and magnetic resonance tomography of the normal temporal bone].

The normal anatomy of the temporal bone and the inner ear will be described in detail on high resolution computed tomography (HRCT) and magnetic resonance images. The imaging technique of computer tomography--either single detector or multi detector CT--is normally obtained in an axial plane without the intravenous application of contrast material. The images are reconstructed in a high resolution bone window level setting. The coronal images are reconstructed either if used single detector or multi detector CT. Only in some cases a scan in the coronal plane is directly obtained using a single detector CT. MR imaging of temporal bone is usually performed in a head coil. Axial high resolution 3D-T2-weighted sequences either in fast spin echo technique or gradient echo technique--for example CISS-sequence--are obtained, then an axial high resolution T1-weighted sequence before and after the application of gadopentate dimiglumine is performed. HRCT excellently demonstrates the osseous structures of the temporal bone as well as of the inner ear, while MRI excellently depicts soft tissue structures especially those of the inner ear. Due to the susceptibility artifacts MRI is not very suitable for imaging the external auditory canal or the middle ear or the pneumatic system. In conclusion HRCT is so far excellent to delineate the osseous structures of the temporal bone and inner ear while MRI excellently depicts the soft tissue structures of the inner ear, the internal auditory canal and the cerebellopontine angle. Reissner's membrane, the cochlear duct, and the organ of Corti cannot be visualized even using high-resolution MRI. HRCT and MRI are therefore used as complementary methods for imaging the temporal bone.

Anatomy, Cross-Sectional↗
PubMed1996

Trauma to the temporal bone: diagnosis and management of complications.

The temporal bone contains important sensory and neural structures that may be damaged in patients who experience craniofacial trauma. The most serious complications of temporal bone trauma include facial nerve paralysis, cerebrospinal fluid leak, and hearing loss. Injury to the temporal bone often presents with subtle signs and symptoms, such as otorrhea, facial palsy, and hemotympanum. A high index of suspicion and a thorough knowledge of how to diagnose injury to the temporal bone are paramount in treating patients who present to the emergency room with craniofacial trauma. This article provides an overview of temporal bone trauma, outlines a methodical approach to the patient with temporal bone trauma, details four cases, and describes the treatment of complications.

Adult↗
PubMed1982

Sclerosing lesions of the temporal bone.

Sclerosis of the mastoid portion of the temporal bone is often seen on radiographs of patients who have or have had chronic otitis media. Occasionally lesions are seen that cause sclerosis of the entire temporal bone. The otolaryngologist must be alert to the fact that these findings may signify important pathology beyond that of chronic otitis media and indeed may be indicative of life threatening problems in adjacent or distant areas. In this paper the differential diagnoses of sclerotic lesions of the temporal bone will be discussed. These include fibrous dysplasia, osteopetrosis, meningioma, ossifying fibroma and metastatic lesions to the temporal bone. Three representative cases with sclerotic temporal bones are presented. The first is a patient with a conductive hearing loss secondary to stenosis of the external auditory canal. He was found to have a fibrous dysplasia of the temporal bone. The second case is an elderly male with a draining ear and a facial nerve paresis. He was found to have adenocarcinoma of the prostate gland metastatic to the temporal bone. The third case is that of a woman with a meningioma who demonstrated a sclerotic temporal bone on routine radiographs of the skull.

Adenocarcinoma↗
PubMed2006

[MRI of the temporal bone].

Lesions arising within the temporal bone, where audition and balance receptors are located, are multiple. Beginning with a short clinical and technical overview, this presentation aims to review the most common temporal bone lesions, according to their location. Tumors and malignant otitis externa are the most common lesions of the external auditory canal. MRI features of cholesteatoma redux, transtegmental masses, and paragangliomas are described in the middle ear MRI study. The diagnosis of petrous apex abnormalities is emphasized: cholesterol granuloma, malignant tumor, epidermoid cyst, cholesteatoma, and petrositis. The diagnostic value of CT scan associated with MRI is stressed. This study also includes the main aspects of facial nerve lesions and vascular abnormalities of the area on MRI. The conclusion summarizes the main indications of temporal bone MRI.

Anticoagulants↗
PubMed1991

Metastatic vaginal carcinoma to the temporal bone.

Metastatic carcinoma of the temporal bone is being reported with increasing frequency. A literature review reveals 16 new cases reported in the past 2 years. In this article we present the first case of vaginal squamous cell carcinoma metastatic to the temporal bone reported in the literature. The pathophysiology, clinical presentation, and diagnostic difficulties of metastatic carcinoma to the temporal bone are discussed.

Aged↗
PubMedDate not supplied

Bilateral cholesterol granulomas of the temporal bone.

Cholesterol granulomas of the temporal bone without clinical symptoms of chronic otitis media may result from an indolent inflammatory process caused by a congenitally blocked group of air cells. A unique case of giant bilateral cholesterol granulomas of the temporal bone is presented to support this theory. Management allowed bilateral surgical removal with hearing preservation. The differentiation between cholesterol granuloma, giant cholesterol cyst and other lesions of the temporal bone is discussed. The presumed pathogenesis of this condition is reviewed.

Bone Diseases↗
PubMed1994

Histopathology of temporal bone fractures: implications for cochlear implantation.

Temporal bone fractures often cause loss of audiovestibular function. Those patients with bilateral profound sensorineural hearing losses secondary to temporal bone fractures become candidates for cochlear implantation. The authors present the histopathology of five temporal bone fractures in three patients, evaluating specifically the traumatic effects on the neural elements of the inner ear. Transverse fractures of the temporal bone result in severe loss of hair cells, ganglion cells, and other supporting cells in the inner ear. Occasionally labyrinthitis ossificans may occur as a consequence of trauma or infection. While longitudinal fractures do not violate the otic capsule, these same neural elements may be damaged by concussion.

Adult↗
PubMed2005

[Computed tomography of the temporal bone in diagnosis of chronic exudative otitis media].

Computed tomography (CT) of the temporal bone was made in 37 patients aged 2 to 55 years with chronic exudative otitis media (CEOM). In 21 of them the pathology was bilateral. The analysis of 58 CT images has identified CT signs of chronic exudative otitis media. They include partial (17 temporary bones) or complete (38 temporal bones) block of the bone opening of the auditory tube, pneumatic defects of the tympanic cavity (58 temporal bones), pneumatic defects of the mastoid process and antrum (47 temporal bones), pathologic retraction of the tympanic membrane. The examination of the temporal bone detected both CT-signs of CEOM and other causes of hearing disorders in 14 patients (26 temporal bones) with CEOM symptoms and inadequately high hypoacusis. Among these causes were malformation of the auditory ossicula (n=5), malformation of the labynthine window (n=2), malformation of the middle and internal ear (n=4), a wide aqueduct of the vestibule, labyrinthine anomaly of Mondini's type (n=1), cochlear hypoplasia (n=4), stenosis of the internal acoustic meatuses (n=2). Sclerotic fibrous dysplasia was suggested in 2 temporal bones (by CT data). CT was repeated after surgical treatment of 10 patients (14 temporal bones) and visual assessment of tympanostomy results was made.

Adolescent↗
PubMed1988

Temporal bone fractures: a clinical diagnosis.

Temporal bone fractures may be complicated by intracranial haemorrhage, C.S.F. leakage and infection, damage to the middle and inner ear and damage to the seventh and eighth cranial nerves. Accurate early diagnosis is important to enable adequate investigation and prompt treatment of any complications. We present eight cases seen in a 12 month period in which a temporal bone fracture was not diagnosed at presentation in spite of a full clinical examination and standard skull radiographs. Five of these cases developed complications which resulted in their referral. The absence of a visible fracture on plain skull radiographs does not exclude a fracture, and those patients with clinical signs of a fracture should be treated appropriately and further investigations performed. Therefore the clinical examination is vital in diagnosing temporal bone fractures and must include careful otoscopy together with assessment of the function of the seventh and eighth cranial nerves.

Adult↗
PubMed1998

Facial reanimation after temporal bone fracture.

Fracture of the temporal bone is usually associated with skull injury and the patient is initially seen in the emergency room. As a result the diagnosis of facial paralysis may be delayed. The aim of this study is to emphasize the importance of early diagnosis and treatment of facial paralysis in such cases. Between 1990 and 1996, sixteen patients with facial paralysis due to temporal bone fracture were operated on within one month of trauma. The surgical technique was selected on the basis of the location of fallopian canal involvement and the patients hearing status. Six patients had grade VI, 7 had grade V and 3 had grade IV facial weakness preoperatively. Twelve patients had serviceable hearing. 9 of them underwent facial decompression through the transmastoid approach and 3 were operated on via the middle fossa approach. Four patients with unserviceable hearing had the operation through the translabyrinthine route. Postoperatively, 15 out of sixteen patients gained normal facial function while one had grade III facial weakness. Severe grade and sudden onset facial paralysis after temporal bone fracture should be surgically corrected as early as possible. The site of involvement of the facial canal and patient's hearing status should be considered in deciding the type of surgery to be applied.

Adolescent↗
PubMed2002

Temporal bone histopathology in CHARGE association.

Three temporal bones obtained at autopsy from 2 patients with CHARGE association (Coloboma, congenital Heart disease, Atresia of choanae, mental Retardation and/or central nervous system anomalies, Genital hypoplasia, and Ear anomalies) were examined histopathologically. Both temporal bones from 1 patient showed multiple anomalies in the middle ear, inner ear, and facial nerve. However, the temporal bone obtained from the other patient showed almost normal structures in the inner ear, middle ear, and eustachian tube. These results are different from those of 2 previous reports of temporal bone histopathology regarding CHARGE association. This difference suggests that CHARGE association may arise not from one etiopathogenetic factor, but from complex factors. Special attention to dehiscent facial canal and perilymphatic gusher during otologic surgery in patients with CHARGE association is discussed.

Abnormalities, Multiple↗
PubMed1977

Management of malignancy of the temporal bone.

An analysis was made of 31 patients with malignancy of the temporal bone treated at Massachusetts Eye and Ear Infirmary between 1959 and 1975. Treatment modalities included: partial temporal bone resection, subtotal temporal bone resection, total temporal bone resection, radical mastoidectomy followed by radiation therapy, radiation therapy alone, and chemotherapy. When tumor was limited to the external ear canal, partial temporal bone resection was effective in 10 out of 11 patients. When tumor involved the middle ear, subtotal temporal bone resection cured 3 out of 5 patients, and radical mastoidectomy followed by radiation therapy cured 5 out of 12 patients. Total temporal bone resection and chemotherapy failed to cure a patient each, but radiation therapy alone was successful in controlling tumor in one patient.

Adult↗
PubMed2001

Temporal bone dissection: a possible route for prion transmission?

The aim of this study was to determine whether neural tissue is present in the bone 'dust' given off during temporal bone drilling. Bone 'dust' from three temporal bone dissections was collected and examined. Evidence of neural tissue was present in two out of the three specimens. Neural tissue is present in the bone dust given off during temporal bone drilling. This poses the question as to the risk of prion transmission during such dissection.

Creutzfeldt-Jakob Syndrome↗
PubMed2004

[Multi-center study of the Jenaer model of the temporal bone].

BACKGROUND: Preparing exercises at the temporal bone are a prerequisite for the knowledge of the anatomical special features of this region and for learning the fundamentals of the tympanic cavity surgery. Since however fewer human temporal bones are available, the search for back-up models already took place in the last years. METHODS: Based on the experiences of the handling and visualization of CT data for the 3D-implant construction in the ent department Jena a temporal bone model was developed. The model was sent away to surgeons of different training. On the basis of identification of anatomical structures and evaluation of general parameters by means of a point system the model was evaluated. RESULTS AND CONCLUSIONS: The Jenaer temporal bone model is suitable as entrance into the preparing exercises. The anatomical structures are good to identify for the beginner. The handling with drill and chisel can be learned.

Attitude of Health Personnel↗
PubMedDate not supplied

Bone scintigraphy in the diagnosis of fracture and infection of the temporal bone.

The sensitivity of 99mTc-MDP-bone-scintigraphy in the diagnosis of temporal bone fracture was found equal to that of conventional radiography if the patients were examined 10 days after the trauma. Temporal bone osteomyelitis with concomitant moderate osteosclerosis was demonstrated by bone scintigraphy in 5 cases of mastoiditis with atypical symptoms. A case of apicitis was for the first time demonstrated by scintigraphy. A low sensitivity of 67Ga-scintigraphy was demonstrated by positive 99mTc-bone-scintigraphy and negative 67Ga-scintigraphy in a patient with atypical mastoiditis. 99mTc-scintigraphy was negative in 5 cases of otitis media suppurativa and in 3 cases of otitis media chronica cum cholesteatoma, all with slight degree of osteosclerosis in the mastoid. The sensitivity of 99mTc-bone-scintigraphy in fracture and osteomyelitis of the temporal bone seems to be a function of the amount of reactive new bone formed.

Adolescent↗