MyMedR

Contrecoup injury in patients with traumatic temporal bone fracture

Asha'Ari ZA, Ahmad R, Rahman J, Kamarudin N, Ishlah LW

J Laryngol Otol, 2011 Aug;125(8):781-5.

PMID: 21524330 DOI: 10.1017/S0022215111000545

To study the prevalence and patterns of contrecoup injury in traumatic temporal bone fracture cases.

Matched MeSH terms: Temporal Bone/injuries*

Patterns of intracranial hemorrhage in petrous temporal bone fracture

Asha'ari ZA, Ahmad R, Rahman J, Yusof RA, Kamarudin N

Auris Nasus Larynx, 2012 Apr;39(2):151-5.

PMID: 21592698 DOI: 10.1016/j.anl.2011.02.010

To study the relationship pattern of intracranial hemorrhage in cases of traumatic petrous temporal bone fracture.

Matched MeSH terms: Temporal Bone/injuries*

Fulltext Temporal bone squamous cell carcinoma - Penang experience

Ng SY, Pua KC, Zahirrudin Z

Med J Malaysia, 2015 Dec;70(6):367-8.

PMID: 26988214 MyJurnal

Temporal bone squamous cell carcinoma (TBSCC) is rare and poses difficulties in diagnosing, staging and management. We describe a case series with six patients who were diagnosed TBSCC, from January 2009 to June 2014, with median age of 62 years old. All patients presented with blood-stain discharge and external auditory canal mass, showing that these findings should highly alert the diagnosis of TBSCC. Three patients staged T3 and another three with T4 disease. High-resolution CT (HRCT) temporal findings were noted to be different from intraoperative findings and therefore we conclude that MRI should be done to look for middle ear involvement or other soft tissue invasion for more accurate staging. Lateral temporal bone resection (LTBR) and parotidectomy was done for four patients with or without neck dissection. Patients with positive margin, perineural invasion or parotid and glenoid involvement carry poorer prognosis and postoperative radiotherapy may improve the survival rate. One patient had successful tumor resection via piecemeal removal approach in contrast with the recommended en bloc resection shows that with negative margin achieved, piecemeal removal approach can be a good option for patients with T2-3 disease. In general, T4 tumor has dismal outcome regardless of surgery or radiotherapy given.

Matched MeSH terms: Temporal Bone

Fulltext Aural Polyp or Temporal Bone Carcinoma: Lesson to Learn

Mahmud KA, Nasseri Z, Mohamed Mukari SA, Ismail F, Abdullah A

Cureus, 2021 Mar 01;13(3):e13629.

PMID: 33816028 DOI: 10.7759/cureus.13629

Temporal bone carcinoma is a rare malignant tumor of the head and neck region. Its clinical presentations can mimic benign ear diseases, leading to inaccurate diagnosis and substandard management. We present the case of a 53-year-old female with a three-month history of progressive right otalgia, otorrhea, and hearing loss. Otoscopic examination revealed a mass occupying the right external auditory canal. However, the lesion was presumed to be an aural polyp by several clinicians previously. Multiple courses of oral antibiotics had been prescribed before she was referred to our clinic for the non-resolving aural polyp. Imaging studies showed an external auditory canal soft tissue mass with extradural and parotid extension. The mass was biopsied, and the result was reported as squamous cell carcinoma of the temporal bone. The patient was advised for a total temporal bone resection and parotidectomy; however, she declined the surgical intervention. Within a month, the tumor had metastasized to her lung, liver, and vertebral bodies. She was referred to the Oncology team for palliative chemo-radiotherapy. Temporal bone malignancy must be considered as a differential diagnosis in a middle-aged or elderly patient with a non-resolving aural polyp without a chronic discharging ear. Imaging studies and histopathological evaluation should be prompted to ascertain the diagnosis. Repeated course of oral antibiotic will delay treatment and subsequently may lead to poor prognosis.

Matched MeSH terms: Temporal Bone

Fulltext Temporal Bone Chondroblastoma: a Rare Entity

Yusof ANM, Thong HK, Kamalden TMIT

Med Arch, 2020 Aug;74(4):312-314.

PMID: 33041452 DOI: 10.5455/medarh.2020.74.312-314

INTRODUCTION: Chondroblastoma is an uncommon benign, locally destructive tumor that usually arises from epiphyses of the long bones. Temporal bone chondroblastoma is an extremely rare occurrence. Chondroblastoma arise from immature cartilage cells and it may display certain malignant features by invading surrounding structures and metastasizing to adjacent sites.

AIM: To present a case of extradural temporal bone chondroblastoma and discuss the clinical presentation, radiographic findings, histology and particularly the surgical management of the case.

CASE REPORT: We report a case of a 31-year-old man who presented with a painless left temporal swelling and left sided hearing loss for four months. Computed tomography (CT) scan revealed an aggressive mass involving the left preauricular region with temporal mastoid bone erosion. Magnetic resonance imaging (MRI) showed an extra-axial left temporal mastoid mass pushing the left temporal lobe superiorly. The patient underwent complete excision of the temporal bone tumor. The final histopathological diagnosis was in keeping with chondroblastoma.

CONCLUSION: Temporal bone chondroblastoma is rare but an aggressive condition. Complete tumor resection via an appropriate approach that enables adequate exposure will lead to a favorable outcome.

Matched MeSH terms: Temporal Bone

Fulltext Endolymphatic sac tumour

Zulkarnaen M, Tang IP, Wong SL

Malays J Pathol, 2012 Jun;34(1):53-5.

PMID: 22870599 MyJurnal

We present a case of a papillary tumour at the cerebellopontine angle in a 41-year-old man. He presented with left-sided facial and ear pain associated with dizziness, nystagmus and hearing loss. CT scan of the temporal bone showed a destructive tumour at the left cerebellopontine angle. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The definitive diagnosis requires a combination of clinical features, radiological finding and pathological correlation.

Matched MeSH terms: Temporal Bone/pathology

Fulltext Familial pattern of large vestibular aqueduct syndrome in a Chinese family

Hazmi M, Ab Aziz A, Asma A

EXCLI J, 2013;12:118-21.

PMID: 27034633

Large Vestibular Aqueduct Syndrome (LVAS) is the most common radiographic malformation in children with early onset of hearing loss. Usually its occurrence is non-familial, however intriguingly a portion of patients with LVAS is found to have evidence of genetic predisposition. We described cases of LVAS in two siblings of a Chinese family. The elder sister first presented with reduced hearing since childhood and her brother has a similar complaint upon further questioning. Their hearing test showed bilateral sensorineural hearing loss (SNHL) and computed tomography (CT) of temporal bone showed enlarged vestibular aqueduct in both patients. We described an approach to diagnosis of LVAS and highlight the importance of hearing assessment in genetic link hearing loss.

Matched MeSH terms: Temporal Bone

Metastatic Adenocarcinoma of Temporal Bone with Collet-Sicard Syndrome

Subha ST, Nordin AJ

Iran J Otorhinolaryngol, 2018 Nov;30(101):361-364.

PMID: 30560103

Introduction: Metastatic tumors of the temporal bone are extremely rare. Collet-Sicard syndrome is an uncommon condition characterized by unilateral palsy of the lower four cranial nerves. The clinical features of temporal bone metastasis are nonspecific and mimic infections such as chronic otitis media and mastoiditis.

Case Report: This report describes a rare case of metastatic adenocarcinoma of the temporal bone causing Collet-Sicard syndrome, presenting with hearing loss, headache and ipsilateral cranial nerve palsies. The patient was a 68-year old woman initially diagnosed with extensive mastoiditis and later confirmed as having metastatic adenocarcinoma of the temporal bone, based on histopathologic findings.

Conclusion: Clinical presentation of metastatic carcinoma of the temporal bone can be overshadowed by infective or inflammatory conditions. This case report is to emphasize the point that a high index of clinical suspicion is necessary for the early diagnosis of this aggressive disease which carries relatively poor prognosis. This report highlights that it is crucial to suspect malignant neoplasm in patients with hearing loss, headache and cranial nerve palsies.

Matched MeSH terms: Temporal Bone

Fulltext Endaural approach of external auditory canal osteoma: report of two cases

Che Mohd Hilmi Che Mat1, Zulkiflee Salahuddin, Nik Azrizie Muhamed, Irfan Mohamad

Journal of Clinical and Health Sciences, 2021;6(1):53-57.

MyJurnal

Osteomas occur in all parts of the temporal bone, including the mastoid, squamous, middle
ear, styloid process, internal auditory canal and external auditory canal (EAC). The EAC has
been reported to be the most common site, followed by the mastoid and squamous parts.
Diagnosis is made based on history, clinical examination and radiological findings. Computed
tomography reveals a pedunculated hyperdense mass that usually arises from the
tympanosquamous suture. Surgical removal of EAC osteomas can be achieved using the
endaural or postauricular approaches. It can be performed with a drill or osteotome, either
endoscopically or by using microscopy. This report presents two patients with EAC osteomas
who underwent excision under microscopy using the endaural approach. Surgery is the gold
standard treatment, while close observation may be considered in asymptomatic patients.

Matched MeSH terms: Temporal Bone

Zygomatic root abscess: A rare entity not to be forgotten!

Hong CX, Razuan NA, Alias A, Hassan FH, Nasseri Z

Auris Nasus Larynx, 2021 Aug;48(4):788-792.

PMID: 32513602 DOI: 10.1016/j.anl.2020.05.007

Zygomatic root abscess is a rare extracranial extratemporal complication of otitis media. To the best of our knowledge, there are only a few scattered cases of zygomatic root abscesses reported in the literature. We present an unusual case of a zygomatic root abscess in a 24 years old adult. He presented with one month duration of right zygomatic swelling. Otoscopic examination revealed superior and posterior external auditory canal wall sagging with an intact tympanic membrane. High Resolution Computed Tomography (HRCT) temporal bone revealed a rim enhancing lesion lateral to the zygomatic process with fluid filled mastoid air cells. He was managed with antibiotics and staged surgical interventions. He recovered well. Our case serves to shed light on the pathways of infection, clinical manifestations and timely staged surgical intervention in this rare pathology.

Matched MeSH terms: Temporal Bone

Candida Skull Base Osteomyelitis: a Case Report and Literature Review

Krishnamoorthy M, Othman NAN, Hassan NEB, Hitam SB

Acta Medica (Hradec Kralove), 2020;63(2):82-85.

PMID: 32771074 DOI: 10.14712/18059694.2020.22

Skull base osteomyelitis (SBO) also commonly known as malignant otitis externa was first described by Meltzer and Kelemen in 1959. Prior to the advent of the antibiotic era, this disease carried a poor prognosis with significant morbidity. It often proved fatal with mortality rates as high as 50%. Commonly seen in the immunocompromised patients, diabetes mellitus is an important associated comorbidity in the pathophysiologic development of this disease. Treatment is instituted by medical therapy with surgery having a limited role. Surgical intervention has a limited role, for example, in fungal SBO. Such cases may require local debridement and intraoperative tissue biopsies for histopathologic confirmation. This is to demonstrate fungal invasion into the skull base, as well as to exclude other sinister differential diagnoses like squamous cell carcinoma of temporal bone. In this case report, we present a rare case of candida SBO and the literature review.

Matched MeSH terms: Temporal Bone

Fulltext Pneumatization of Mastoid Air Cells, Temporal Bone, Ethmoid and Sphenoid Sinuses. Any Correlation?

Hindi K, Alazzawi S, Raman R, Prepageran N, Rahmat K

Indian J Otolaryngol Head Neck Surg, 2014 Dec;66(4):429-36.

PMID: 26396957 DOI: 10.1007/s12070-014-0745-z

The aim of this study is to assess the pneumatization of the paranasal sinuses (PNS) and other parts of temporal bone such as mastoid air cells and to investigate if there was any association between the aeration of these structures among the three major ethnic groups in Malaysia (Malay, Chinese, Indian) as this would be representative of Asia. A retrospective review of 150 computed tomography (CT) scans of PNS and temporal bones was done and analysed. The pneumatization of each area was obtained and compared using statistical analysis. Patients with a history of previous medical or surgical problems in the intended areas were excluded from the study. The pneumatization of the mastoid air cells and other temporal bone parts were noted to be symmetrical in more than 75 %. There was a positive correlation between the pneumatization of mastoid air cells and that of the sphenoid sinus. The prevalence of Agger nasi, Haller's and Onodi cells was observed to be significantly higher in the Chinese group. Preoperative assessment of the temporal bone and PNS with CT scan may be helpful in the evaluation of their anatomical landmark and decrease the possibility of surgical complications related to 3D structures.

Matched MeSH terms: Temporal Bone

Fulltext The Correlation Between Pre and Postoperative Hearing Level with High Resolution Computed Tomography (HRCT) Findings in Congenital Canal Atresia (CAA) Patients

Asma A, Abdul Fatah AW, Hamzaini AH, Mazita A

Indian J Otolaryngol Head Neck Surg, 2013 Dec;65(Suppl 3):526-31.

PMID: 24427708 DOI: 10.1007/s12070-011-0438-9

In managing patient with congenital congenital aural atresia (CAA), preoperative high resolution computed tomography (HRCT) scan and hearing assessment are important. A grading system based on HRCT findings was first introduced by Jahrsdoefer in order to select appropriate candidates for operation and to predict the postoperative hearing outcome in CAA patients. The score of eight and more was considered as a good prognostic factor for hearing reconstruction surgery. However previously in our center this score was not used as the criteria for surgical procedure. This study was conducted at Center A to evaluate the correlation between pre and postoperative hearing level with HRCT based on a Jahrsdoefer grading system in patients with CAA. All records and HRCT films with CAA from January 1997 until December 2007 at Center A were evaluated. The demographic data, operative records, pre and post operative hearing levels and HRCT findings were analyzed. Hearing level in this study was based on a pure tone average of air-bone gap at 500 Hz, 1 kHz and 2 kHz or hearing level obtained from auditory brainstem response eudiometry. This study was approved by Research Ethics Committee (code number, FF-197-2008). Thirty-two ears were retrospectively evaluated. The postoperative hearing level of 30 dB and less was considered as successful hearing result postoperatively. Of the six ears which underwent canalplasty, three had achieved successful hearing result. However, there was no significant correlation between preoperative hearing level (HL) with HRCT score and postoperative HL with HRCT score at 0.05 significant levels (correlation coefficient = -0.292, P = 0.105 and correlation coefficient = -0.127, P = 0.810) respectively. Hearing evaluation and HRCT temporal bone are two independent evaluations for the patients with CAA before going for hearing reconstructive surgery.

Matched MeSH terms: Temporal Bone

Fulltext Rare case of temporal bone carcinoma with intracranial extension

Kasim KS, Abdullah AB

Indian J Otolaryngol Head Neck Surg, 2012 Dec;64(4):397-8.

PMID: 24294589 DOI: 10.1007/s12070-011-0250-6

Temporal bone cancer, a relatively rare disease, accounting for less than 0.2% of all tumors of the head and neck and is associated with a poor outcome; often presents in a subtle manner, which may delay diagnosis. It should be suspected in any case of persistent otitis media or otitis externa that fails to improve with adequate treatment. Despite advances in operative technique and postoperative care, long-term survival remains poor). It includes cancers arising from pinna that spreads to the temporal bone, primary tumors of the external auditory canal (EAC), middle ear, mastoid, petrous apex, and metastatic lesions to the temporal bone. Here is a report on a case of temporal bone carcinoma presenting with right otalgia, otorrhea and facial paralysis. The patient was initially diagnosed as mastoiditis and later the clinical impression was revised to temporal bone carcinoma (undifferentiated type), based on the pathologic findings.

Matched MeSH terms: Temporal Bone

Surgical management of tympanojugular paragangliomas with intradural extension, with a proposed revision of the Fisch classification

Sivalingam S, Konishi M, Shin SH, Lope Ahmed RA, Piazza P, Sanna M

Audiol. Neurootol., 2012;17(4):243-55.

PMID: 22584244 DOI: 10.1159/000338418

Tympanojugular paragangliomas (TJPs) with intradural extension can be successfully treated by a single or staged procedure with low surgical morbidity.

Matched MeSH terms: Temporal Bone/surgery*

Fulltext Head injury with temporal bone fracture: one year review of case incidence, causes, clinical features and outcome

Amin Z, Sayuti R, Kahairi A, Islah W, Ahmad R

Med J Malaysia, 2008 Dec;63(5):373-6.

PMID: 19803293 MyJurnal

To investigate the case incidence, causes, clinical profile and outcome of temporal bone fracture complicating head trauma. A 1-year (2005) retrospective study of head injured patients presented to the Emergency Department, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia. Gender distribution, cause of injury, radiological findings and otorhinolaryngological clinical presentations were analyzed. Of 1309 patients, 61 patients were diagnosed to have temporal bone fracture (4.7%). Majority of cases were caused by motor vehicle accident (85.9%) and were predominantly male (88.5%). The right temporal bone was more frequently fractured (62.3%). Most (88.5%) were petro-mastoid fractures. Sixty-seven percent of the petrous fractures were longitudinal type. Clinical presentations mostly reported were blood rhinorrhea (36%) and blood otorrhea (32.7%). Other clinical presentations were hearing loss (9.8%), cranial nerve palsy (8.2%), cerebrospinal fluid oto-rhinorrhea (8.2%) and labyrinth concussion (6.5%). Four out of five cranial nerve palsies were facial nerve. Out of the 61 cases, 16 (26.2%) had no clinical presentation at the time of Emergency Department consultation. Thirteen (21.3%) died due to severe head injury. The case incidence of temporal bone fracture in head injured patients in our centre is 4.7%. The petro-mastoid type fracture predominates. Proper early diagnosis and management minimize complications.

Matched MeSH terms: Temporal Bone/injuries*

Therapeutic approach in managing patients with large vestibular aqueduct syndrome (LVAS)

Asma A, Anouk H, Luc VH, Brokx JP, Cila U, Van De Heyning P

Int J Pediatr Otorhinolaryngol, 2010 May;74(5):474-81.

PMID: 20189254 DOI: 10.1016/j.ijporl.2010.01.023

To discuss the clinical approach in managing patients with large vestibular aqueduct syndrome.

Matched MeSH terms: Temporal Bone/radiography

Fulltext Large vestibular aqueduct syndrome

Dipak S, Prepageran N, Sazila AS, Rahmat O, Raman R

Med J Malaysia, 2005 Oct;60(4):489-91.

PMID: 16570713

Large Vestibular Aqueduct Syndrome is a congenital malformation of the temporal bone characterised by early onset of sensorineural hearing loss and vestibular disturbance. Familial large vestibular aqueduct syndrome suggests autosomal recessive or X-linked inheritance and accounts for non-syndromic sensorineural hearing loss in these patients.

Matched MeSH terms: Temporal Bone/abnormalities*

Fulltext Eagle's syndrome

Subramaniam S, Abd Majid MD

Med J Malaysia, 2003 Mar;58(1):139-41.

PMID: 14556342

Eagle's syndrome is an uncommon condition resulting from an elongated styloid process, which causes cervico facial pain, tinnitus and otalgia. A 48-year-old female presented to the clinic with bilateral upper neck pain radiating to the ears with tinnitus for almost one-year duration. Examination of the oral cavity revealed atrophic tonsils and palpable bony projection deep in the tonsillar fossa. Plain lateral neck X-ray and CT scan confirmed the presence of bilateral elongated styloid processes, which were subsequently resected surgically through an oropharyngeal approach. The patient was asymptomatic at follow up at 2 years.

Matched MeSH terms: Temporal Bone/abnormalities*

Delayed traumatic extradural haematomas

Chandrasekaran S, Zainal J

Aust N Z J Surg, 1993 Oct;63(10):780-3.

PMID: 8274120

A total of 76 patients with traumatic extradural haematoma were treated within a period of 3 years. Four patients developed delayed extradural haematomas. These cases are reported in view of the unusual sequence and the importance of early diagnosis.

Matched MeSH terms: Temporal Bone/injuries

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