Assuntos
Burkholderia cepacia , Fibrose Cística/complicações , Infecções Oportunistas/complicações , Osteomielite/complicações , Infecções por Pseudomonas/complicações , Adulto , Burkholderia cepacia/patogenicidade , Fibrose Cística/cirurgia , Feminino , Humanos , Transplante de Pulmão/imunologia , Osteomielite/microbiologia , Otite Média/microbiologia , VirulênciaRESUMO
The prostheses available for reconstruction of the ossicular chain have expanded to include a variety of synthetic materials. Hydroxyapatite contains the inorganic constituents found in human living bone and is currently being incorporated into many new prostheses. This study demonstrates the computed tomography and magnetic resonance image characteristics of eight middle ear prostheses, a block of dense hydroxyapatite, and a human incus. Imaging of ossicular prostheses is more informative with computed tomography.
Assuntos
Prótese Ossicular , Substitutos Ósseos , Durapatita , Humanos , Bigorna/anatomia & histologia , Bigorna/diagnóstico por imagem , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
The anatomy of the facial nerve relative to its intratemporal and extratemporal courses varies over time with developmental changes. Otologic and parotid surgery in infants and children demands detailed knowledge of the precise anatomy of the facial nerve with respect to the tympanic ring and external auditory canal. The authors analyzed this area using our three-dimensional (3-D) computer-aided reconstruction and measurement method studying the spatial relations of the facial nerve to the tympanic ring and stylomastoid foramen. Temporal bones from five normal individuals aged 36 gestational weeks, 3 months, 8 months, 4 years, and 17 years were retrieved from the temporal bone collection stored at the Elizabeth McCullough Knowles Otopathology Laboratory in Pittsburgh. Three-dimensional reconstruction of the facial nerve comparing the developmental anatomy across the various age groups provides the surgeon with the technical information necessary to address problems in this area.
Assuntos
Nervo Facial/anatomia & histologia , Processamento de Imagem Assistida por Computador , Processo Mastoide/inervação , Adolescente , Envelhecimento , Pré-Escolar , Nervo da Corda do Tímpano/anatomia & histologia , Desenho Assistido por Computador , Meato Acústico Externo/inervação , Orelha Média/inervação , Nervo Facial/embriologia , Feminino , Feto , Humanos , Lactente , Masculino , Osso Temporal/inervaçãoRESUMO
A retrospective review was done, examining the charts of 41 patients admitted to The Eye and Ear Hospital of Pittsburgh with a diagnosis of sudden hearing loss (SHL). Treatment consisted of (1) systemic steroids; (2) daily intravenous histamine infusion; and (3) carbogen (95% oxygen and 5% CO2) inhalation. Parameters examined included age, sex, duration of symptoms prior to admission, days hospitalized, side of lesion, vestibular symptoms, tinnitus, blood work, radiography, vestibular function (ENG), and serial audiograms. Fifty-four percent showed improvement in hearing, defined as at least a 10-dB increase at any frequency following therapy. There was no correlation of preexisting signs, symptoms, or findings with hearing recovery. Since the natural history of this process demonstrates spontaneous improvement in approximately two thirds of patients without treatment, we conclude that for the group of patients that we treated, our therapeutic regimen was ineffectual.
Assuntos
Otopatias/fisiopatologia , Orelha Média/fisiopatologia , Perda Auditiva Neurossensorial/tratamento farmacológico , Adolescente , Adulto , Audiometria , Terapia Combinada , Otopatias/tratamento farmacológico , Orelha Média/efeitos dos fármacos , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Histamina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Oxigenoterapia , Estudos Retrospectivos , Esteroides/administração & dosagem , Esteroides/farmacologia , Esteroides/uso terapêutico , Resultado do TratamentoRESUMO
The large vestibular aqueduct syndrome describes an abnormally large endolymphatic duct and sac with associated sensorineural hearing loss. This entity was originally reported in 1978 and has since been identified as a finding in children with progressive hearing loss. The original description of the large vestibular aqueduct employed hypocycloidal polytomography of temporal bone. Subsequent reports studied patients identified with this syndrome using computed tomographic scans. We report magnetic resonance imaging of two patients diagnosed with the large vestibular aqueduct syndrome. The magnetic resonance imaging and computed tomographic scans are compared and the significant findings on magnetic resonance imaging are reviewed. This should assist the otolaryngologist and radiologist with establishing the appropriate diagnosis.
Assuntos
Transtornos da Audição/fisiopatologia , Aqueduto Vestibular/patologia , Doenças Vestibulares/diagnóstico , Adulto , Feminino , Perda Auditiva/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndrome , Tomografia Computadorizada por Raios X , Doenças Vestibulares/diagnóstico por imagemRESUMO
High signal from the otic labyrinth was observed on precontrast MR scan of two patients who presented with sudden hearing loss and vertigo. The authors suggest the possibility that the high signal was caused by hemorrhage but that clinical significance and therapeutic implications of this finding need further study.
Assuntos
Orelha Interna/patologia , Perda Auditiva/patologia , Imageamento por Ressonância Magnética , Vertigem/patologia , Adulto , Perda Auditiva/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Vertigem/complicaçõesAssuntos
Orelha Externa , Otite Externa , Aciclovir/uso terapêutico , Antibacterianos/uso terapêutico , Doença Crônica , Orelha Externa/anatomia & histologia , Furunculose , Herpes Zoster da Orelha Externa/diagnóstico , Herpes Zoster da Orelha Externa/tratamento farmacológico , Humanos , Micoses/tratamento farmacológico , Otite Externa/diagnóstico , Otite Externa/tratamento farmacológico , Otite Externa/terapiaRESUMO
A 25-year-old male underwent right mastoid surgery for removal of a soft tissue mass. At age 29 a left cardiac atrial myxoma was excised. At age 34 an expanding right supra-auricular mass with extension into the middle and posterior fossa necessitated total temporal bone resection. Pathology proved to be myxoma. Retrospective review of tissue obtained from the initial mastoid procedure was also myxoma. The temporal bone lesion was considered to be persistent and metastatic atrial myxoma. A review of atrial myxomas and this most unusual metastatic presentation is discussed.
Assuntos
Neoplasias Cardíacas/patologia , Mixoma/secundário , Neoplasias Cranianas/secundário , Osso Temporal/patologia , Adulto , Átrios do Coração , Humanos , Masculino , Mixoma/patologia , Neoplasias Cranianas/patologiaRESUMO
A retrospective study of 35 patients with squamous cell carcinoma of the external auditory meatus treated at the Eye and Ear Hospital of the University of Pittsburgh was performed. The standard treatment was a temporal bone resection that corresponded to the extent of the lesion, followed by postoperative radiation therapy. The tumor extensions, symptoms, treatments, survival rates, and prognostic variables were reviewed. Overall, 12 of 35 patients survived. Lesions limited to the external auditory meatus with no erosion had excellent prognoses. Survival in intermediate lesions with bony erosion or middle ear involvement was related to the status of surgical margins after partial or subtotal temporal bone resections. Extensive lesions that involved the surrounding soft tissue or dura had poor prognoses. The survival value of total temporal bone resection remains unproved.