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PubMed1989

[Revision after surgical procedures in the middle ear and mastoid].

In a group of 46 revised operations the most frequent cause of revision was persisting secretion--in 41 patients. After elimination of general causes and after failure of conservative treatment, during revision the following local causes were revealed: relapse of cholesteatoma in 44%, inflammation of the residual or repneumatized spaces in 41%, ostitis of the long process of the incus in 10% and inflammation in the divided trepanation cavities in 5%. By the first revision the authors achieved a dry trepanation cavity in 58.5% of the operated patients. By the second and third revision they increased the number of dry trepanation cavities to 83% and in the remaining ones there was only an occasional secretion. The revision involved usually a more radical procedure. In some of the patients operated by the "closed" technique the authors changed to the "open" technique. A radical approach to the auditory ossicles and the ear drum, if they were preserved during the primary operation, led to a deterioration of hearing in 22 of 41 operated patients, i. e. in 53.66%. This is the cost of obtaining a dry trepanation cavity.

Adolescent↗
PubMed1986

Magnetic resonance imaging of traumatic sinus and mastoid bleeding.

Magnetic resonance imaging (MRI) characterized intrasinus hemorrhage in 8 out of 10 patients with computed tomography (CT) evidence of post-traumatic sinus opacification. Fractures of sinus walls were demonstrated as disruptions in the hypointense line of the bony wall, as displacement of this line, or by increased signal from blood or sinus effusion within the fracture. Seven patients with fractures of the temporal bone were more difficult to evaluate because of the hypointensity of air trapped within the fracture line mimicing the bony wall and that within the middle ear mimicing the ossicles; 1.5 tesla MR proved superior to CT in demonstrating associated extra- and intracerebral hemorrhage.

Hemorrhage↗
PubMed1987

[Further development of pneumatization of the mastoid apophysis in long-term drainage of the tympanum].

Tubal insufficiency evoked by inflammation or mechanical obstruction due to enlarged adenoids plays an important role in the pathogenesis of chronic serous otitis media. Serous and mucous tympanic effusions in the presence of immature middle ear mucosa and pneumatisation follow. An adhesive process can be the result. Secretory outflow as well as constant pressure compensation between the tympanic cavity and the auditory meatus can only be achieved by a long-term tympanic drainage. Progression of pneumatisation is achieved by recovery of the middle ear mucosa and in most cases an adhesive process can be prevented.

Child↗
PubMed1988

Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings.

High-resolution CT scanning accurately depicts the status of the structures of the temporal bone, allowing delineation of pathology prior to surgical exploration of ears with cholesteatoma. It provides information concerning location and extent of disease as well as possible anatomic variations and complications that may be encountered. The main advantages of CT scanning over polytomography are superior soft-tissue contrast resolution and improved spatial detail at a reduced radiation dose for the patient.

Bone Diseases↗