RESUMO
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 XAssuntos
Orelha Interna/patologia , Labirintite/patologia , Ossificação Heterotópica/patologia , Adulto , Audiometria , Surdez/diagnóstico , Orelha Interna/diagnóstico por imagem , Orelha Média/patologia , Feminino , Humanos , Doenças do Labirinto/complicações , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/patologia , Labirintite/complicações , Labirintite/diagnóstico , Ossificação Heterotópica/complicações , Ossificação Heterotópica/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
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
Odontoma of the middle ear cleft is an unusual cause of conductive hearing loss. We report two cases and discuss the developmental mechanism by which this anomaly may occur. The differential diagnosis of calcified masses in the middle ear is also discussed.
Assuntos
Neoplasias da Orelha/complicações , Orelha Média , Perda Auditiva Condutiva/etiologia , Odontoma/complicações , Adulto , Criança , Neoplasias da Orelha/patologia , Feminino , Humanos , Odontoma/patologiaRESUMO
A multidisciplinary approach to the study of a family with autosomal dominant sensorineural hearing loss is presented. The affected family members underwent extensive clinical and laboratory evaluation. They were found to have various degrees of bilateral congenital inner ear anomalies as imaged by computed tomography. The degree of structural abnormalities in the inner ears correlated with the severity of hearing impairment. Vestibular testing revealed nonspecific abnormalities generally correlating with audiologic and radiographic findings. This report presents a unique form of sensorineural hearing loss not previously described and is the first in-depth clinical study of nonsyndromal "Mondini dysplasia" occurring in a family.
Assuntos
Perda Auditiva Neurossensorial/genética , Adulto , Audiometria , Criança , Pré-Escolar , Potenciais Evocados Auditivos do Tronco Encefálico , Família , Feminino , Genes Dominantes , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Masculino , Linhagem , Tomografia Computadorizada por Raios X , Testes de Função VestibularRESUMO
Survival is related to the pathologic extent of tumor in external auditory meatus (EAM) carcinoma. This study assesses the validity of preoperative CT scans in staging EAM carcinoma. The accuracy of staging EAM carcinoma with preoperative CT scans was evaluated by comparing radiography and histopathology. Patients who received preoperative CT scan were selected from a retrospective series of 35 temporal bone resections for EAM squamous cell carcinoma. The CT scans were systematically reviewed for tumor involvement in 12 anatomic areas. The histopathology slides for the corresponding patients were reviewed according to the same criteria. CT scan findings accurately diagnosed the extent of tumor involvement identified during histopathologic examination. These tumors demonstrated the capacity to spread along existing anatomic pathways as well as direct bone erosion. We conclude that preoperative CT scans accurately stage EAM squamous cell carcinoma.
Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Meato Acústico Externo , Neoplasias da Orelha/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Meato Acústico Externo/diagnóstico por imagem , Neoplasias da Orelha/patologia , Neoplasias da Orelha/cirurgia , HumanosRESUMO
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.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Meato Acústico Externo , Neoplasias da Orelha/cirurgia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Neoplasias da Orelha/mortalidade , Neoplasias da Orelha/radioterapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Osso Temporal/cirurgiaRESUMO
This study compares the results from simultaneous binaural bithermal and alternate binaural bithermal caloric testing of 652 patients with dizziness. Also compared are the abilities of these tests to distinguish between a population of healthy asymptomatic subjects and our patient population. Caloric testing used a closed-loop irrigation system. Eye movements were monitored with electro-oculography. The agreement between the results from the two tests was low. Also, while the simultaneous test was more sensitive, the alternate test was more specific. Using receiver-operator characteristic methodology, it was found that the ability of the alternate test to distinguish between a healthy population and a patient population was superior to that of the simultaneous test. There was no improvement in the ability to distinguish between a healthy population and a patient population when the results from the two tests were combined as compared to using the alternate caloric test alone.