11/92. 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.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
12/92. Otolaryngological manifestations of ligneous conjunctivitis.Ligneous conjunctivitis is a rare condition that can involve the mucous membranes of the upper and lower airways and temporal bone extensively. This can lead to life threatening airway obstruction. Involvement of the middle ear and mastoid may cause significant conductive hearing loss. This is the first reported case with temporal bone sections of ligneous conjunctivitis, and awareness of the associated obstructive hydrocephalus may prevent death in this condition. Evidence suggests that plasminogen deficiency may be a causative factor in ligneous conjunctivitis, and this finding may offer new prospects for management.- - - - - - - - - - ranking = 0.2keywords = bone (Clic here for more details about this article) |
13/92. Spontaneous temporal bone cerebrospinal fluid leak.Eight patients with spontaneous cerebrospinal fluid leak of temporal bone origin are presented. Pertinent history and surgical findings are reviewed and contrasted with 33 previously reported patients. Unilateral ear fullness and mild hearing loss are the most common presenting symptoms. Profuse clear otorrhea following myringotomy is virtually pathognomonic. Diagnostic methods including high-resolution computed tomography, magnetic resonance imaging, and contrast cisternography are discussed. The indications for transmastoid and combined transmastoid/middle fossa surgical repairs are compared. Both surgical approaches were found to be equally effective. We favor the transmastoid as the initial approach because of simplicity, safety, and the ability to visualize both the middle fossa and posterior fossa plates as well as the middle ear.- - - - - - - - - - ranking = 0.5keywords = bone (Clic here for more details about this article) |
14/92. Inflammatory pseudotumor of the temporal bone.OBJECTIVE: To characterize the clinical presentation, imaging characteristics, intraoperative findings, and key histopathologic features of inflammatory pseudotumors of the temporal bone. Findings from an index case are presented, and the literature is reviewed for comparison. STUDY DESIGN: Retrospective case review. SETTING: University tertiary referral center. patients: Cases were identified by review of surgical specimens from the temporal bone and lateral skull base with histopathologic confirmation. A single case was identified at our institution. Nine additional cases were identified in the literature; clinical features were reviewed. INTERVENTION: Of reported cases, treatment consisted of complete surgical excision in eight cases and subtotal excision in one. The index patient underwent surgical excision with postoperative corticosteroid therapy for adjacent meningeal involvement, after histopathologic interpretation. Corticosteroids were administered to one patient with residual microscopic tumor, and external beam radiotherapy was used for residual/recurrent disease in one case. RESULTS: The lesions were typically locally aggressive with extensive bony erosion. Three cases (33%) demonstrated labyrinthine and otic capsule involvement. Four cases (44%) involved the facial nerve. Characteristic histopathologic features included fibroblastic proliferation and a mixed inflammatory cell infiltrate in all cases. Mitotic figures, nuclear pleomorphism, and necrosis were rare or nonexistent. CONCLUSIONS: Inflammatory pseudotumors of the temporal bone are rare but aggressive lesions. Therapy should consist of surgical excision with steroids reserved for residual or intracranial disease or in patients in whom surgery is not an option. These lesions must be differentiated from other infectious, granulomatous, and neoplastic lesions on the basis of histopathologic and immunohistochemical findings.- - - - - - - - - - ranking = 0.7keywords = bone (Clic here for more details about this article) |
15/92. osteopetrosis of temporal bone with blockage of the eustachian tube. A case report.osteopetrosis is an inherited disorder characterized by bone sclerosis. One of the more predominant feature of the disease in the temporal bone is conductive hearing loss due to anomalous bone formation in the middle ear and to otitis media. A 55-year-old woman affected by the adult type of osteopetrosis was referred to our department with a long history of otitis media. CT study demonstrated a narrowing of eustachian tube due to abnormal deposition of sclerotic bone; this condition was confirmed during surgery. Tubotomy was performed during tympanoplastic surgery and there were no relapse of otitis after 12 months of follow up. Timpanoplastic surgery should be considered in those cases where medical treatment has failed in dealing with otitis media. In our experience an enlargement of eustachian tube shuld be performed in this kind of patients, thus helping the functional recovery and the potential well-being of the patient as we observed in our case.- - - - - - - - - - ranking = 0.8keywords = bone (Clic here for more details about this article) |
16/92. Idiopathic bilateral auricular ossificans: a case report and review of the literature.Petrification of the auricle results in a rigid and immalleable ear. The etiology of such a finding is usually ectopic calcification. The condition has been associated with injurious processes, such as cold injury, and with various endocrinopathies, including addison disease. In a significant number of cases, ossification occurs without knowledge of the precipitating cause or event. True auricular ossification is a rare occurrence, with only 12 histologically confirmed cases in the literature. We herein present the clinical and pathologic findings of another case. A 60-year-old man with diet-controlled diabetes presented with a 10-year history of slowly and insidiously stiffened auricles. He denied any precipitating historical events. Routine testing did not demonstrate systemic abnormalities. Radiographic examination revealed opacities consistent with bony structure in the auricles of the ears, with the right more prominent than the left. Histologic sampling demonstrated ossification with deposition of trabecular bone in proximity to normal elastic cartilage.- - - - - - - - - - ranking = 0.1keywords = bone (Clic here for more details about this article) |
17/92. Temporal giant cell reparative granuloma: a reappraisal of pathology and imaging features.We report a case of large temporal giant cell reparative granuloma in a 72-year-old man. MR imaging depicted a right temporal expansile multiloculated lesion, with hyper- and hypointense signal areas on T2-weighted images, heterogeneously enhancing after gadolinium administration. Cortical thinning and bone remodeling of the temporal squamous portion were better seen on CT. The patient underwent surgery, and the diagnosis was achieved by the correlation of imaging, histologic, and laboratory findings.- - - - - - - - - - ranking = 0.1keywords = bone (Clic here for more details about this article) |
18/92. plasma cell granuloma of the middle ear and mastoid. Case report.We present the case of a 37-year-old man with plasma cell granuloma affecting the middle ear and mastoid. At magnetic resonance imaging scan, the lesion appeared as a homogeneously enhancing mass of soft tissue replacing the majority of the mastoid bone and causing vascular compression. After surgical resection, microscopic examination showed predominantly plasmacytes, and histochemical studies confirmed a polyclonal origin consistent with nonneoplastic plasma cell granuloma. We believe this is the first case report of plasma cell granuloma affecting the middle ear and mastoid.- - - - - - - - - - ranking = 0.1keywords = bone (Clic here for more details about this article) |
19/92. Spontaneous hemotympanum associated with chronic middle ear effusion.Idiopathic or spontaneous hemotympanum (SH) is an uncommon disorder characterized by a black-blue tympanic membrane discoloration as a result of recurrent hemorrhage in the middle ear or mastoid in the presence of eustachian tube obstruction. Initial evaluation of a blue middle ear mass includes an audiogram and computed tomography (CT) scan with intravenous contrast. CT may identify congenital vascular malformation or bone erosion due to chronic otitis media or tumors. A magnetic resonance imaging (MRI) scan is useful in distinguishing hemotympanum from a vascular tumor and avoiding angiography, which is associated with significant morbidity. Evidence suggests that secretory otitis media and SH are different phases of the same disease process.- - - - - - - - - - ranking = 0.1keywords = bone (Clic here for more details about this article) |
20/92. The fate of bone grafts in deep oval windows.The use of bone grafts for total ossicular chain reconstructions in patients with deep oval windows may result in varying degrees of absorption of the segment of the bone graft in the fossula fenestra vestibuli. The mechanism of bone absorption is described--a condition not described before.- - - - - - - - - - ranking = 0.7keywords = bone (Clic here for more details about this article) |
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