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1.
Medicine (Baltimore) ; 99(11): e19487, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176085

RESUMO

RATIONALE: Chondromyxoid fibroma (CMF) is a rare form of benign bone tumor and easily misdiagnosed as fibrosarcoma. Hence, to explore the clinical manifestations, diagnostic tests, and therapeutic procedures for temporal bone cartilage myxoid fibroma, it is important to optimize patient treatment and avoid overtreatment. Previous research has discussed cases of CMF, but this paper presents a systematic, complete, and comprehensive introduction of this disease based on this case and related literature. PATIENT CONCERNS: A 52-year-old male patient presented with pain in his right ear for 2 years and hearing loss in his right ear with tinnitus for 1 year. The patient had a history of hypertension for 9 years and it was well-controlled. DIAGNOSIS: A computed tomography (CT) scan of the temporal bone showed an expansive growth on the right temporal bone plate and tympanic plate, presenting as a cloud-like ground glass opaque shadow involving the temporom and ibular joint, middle skull base, and small auditory bones. A magnetic resonance imaging (MRI) of the temporal bone showed a large and irregular soft tissue mass shadow on the right temporal bone plate. The right temporal bone plate was occupied by the lesion, consistent with a bone origin. From the results of the imaging examination of the patient, a lesion occupying the temporal bone in the right ear and mastoiditis in the right middle ear was initially diagnosed. INTERVENTIONS: Right ear temporal bone tumor resection and abdominal fat extraction were conducted. OUTCOMES: Postoperative pathological results demonstrated myxoid fibroma of the temporal bone cartilage. No recurrence or severe complications were observed in 8 months of follow-up. LESSONS: A finding of myxoid fibroma of the temporal bone cartilage is rare in the clinic. The growth of such tumors is slow. The temporal bone CT and inner ear MRI were helpful in diagnosis. Surgery was the principal treatment.


Assuntos
Condroma/diagnóstico por imagem , Neoplasias Cranianas/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Condroma/complicações , Condroma/cirurgia , Diagnóstico Diferencial , Perda Auditiva/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Cranianas/complicações , Neoplasias Cranianas/cirurgia , Zumbido/etiologia , Tomografia Computadorizada por Raios X
2.
J Laryngol Otol ; 134(3): 205-212, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32122408

RESUMO

OBJECTIVE: To review the management of temporal bone fractures at a major trauma centre and introduce an evidence-based protocol. METHODS: A review of reports of head computed tomography performed for trauma from January 2012 to July 2018 was conducted. Recorded data fields included: mode of trauma, patient age, associated intracranial injury, mortality, temporal bone fracture pattern, symptoms and intervention. RESULTS: Of 815 temporal bone fracture cases, records for 165 patients met the inclusion criteria; detailed analysis was performed on the records of these patients. CONCLUSION: Temporal bone fractures represent high-energy trauma. Initial management focuses on stabilisation of the patient and treatment of associated intracranial injury. Acute ENT intervention is directed towards the management of facial palsy and cerebrospinal fluid leak, and often requires multidisciplinary team input. The role of nerve conduction assessment for immediate facial palsy is variable across the UK. The administration of high-dose steroids in patients with temporal bone fracture and intracranial injury is not advised. A robust evidence-based approach is introduced for the management of significant ENT complications associated with temporal bone fractures.


Assuntos
Prática Clínica Baseada em Evidências/métodos , Equipe de Assistência ao Paciente , Fraturas Cranianas/terapia , Osso Temporal/lesões , Adulto , Vazamento de Líquido Cefalorraquidiano/etiologia , Vazamento de Líquido Cefalorraquidiano/terapia , Criança , Protocolos Clínicos , Paralisia Facial/etiologia , Paralisia Facial/terapia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fraturas Cranianas/complicações , Fraturas Cranianas/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Centros de Traumatologia , Reino Unido
3.
J Laryngol Otol ; 134(4): 366-368, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32106896

RESUMO

BACKGROUND: Individuals with superior semi-circular canal syndrome often describe vestibular symptoms elicited by loud sounds, as well as other pressure-induced symptoms. They also often report other symptoms, including autophony, hyperacusis, cognitive dysfunction, spatial disorientation, anxiety and migraine headaches. Symptoms occur due to the presence of a 'third window' created by the dehiscence of the superior semi-circular canal. This case report describes a minimally invasive technique to provide soft reinforcement of the round window. CASE REPORT: Our patient underwent a permeatal procedure whereby the tympanic membrane was raised to allow inspection of the middle ear. The round window niche was identified and the round window membrane was reinforced with fat. The mucosa of the bony meatus leading to the round window was then disrupted before the application of a double layer of perichondrium to allow further reinforcement. CONCLUSION: The case provides support for the use of 'soft reinforcement' as a simple and effective technique to treat the symptoms of superior canal dehiscence syndrome.


Assuntos
Orelha Interna/cirurgia , Janela da Cóclea/cirurgia , Canais Semicirculares/cirurgia , Orelha Interna/patologia , Orelha Interna/fisiopatologia , Orelha Média/cirurgia , Feminino , Humanos , Hiperacusia/diagnóstico , Hiperacusia/etiologia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Canais Semicirculares/patologia , Síndrome , Osso Temporal/diagnóstico por imagem , Zumbido/diagnóstico , Zumbido/etiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Potenciais Evocados Miogênicos Vestibulares/fisiologia
4.
Artigo em Chinês | MEDLINE | ID: mdl-32086914

RESUMO

Objective:The aim of this study is to evaluate the diagnostic value of turbo spin-echo(TSE) diffusion weighted imaging(DWI) in temporal bone cholesteatoma. Method:A prospective evaluated of 76 patients with suspected sacral cholesteatoma was performed using a Philips Ingenia 3.0T superconducting magnetic resonance scanner and a 32-channel head coil with turbo spin-echo diffusion weighted imaging(TSE-DWI) sequence and conventional magnetic resonance scan, and underwent surgery within the next two weeks. The pathological result is the gold standard, and the imaging diagnosis and surgery are performed. The intraoperative observation and pathological results were compared. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TSE-DWI sequence in the diagnosis of temporal bone cholesteatoma were calculated. Result:Of the 76 patients with suspected temporal bone cholesteatoma, TSE-DWI scan was performed, 44 cases were diagnosed as cholesteatoma and 32 cases were non-cholesteatoma. Based on the pathology results, 46 cases were diagnosed as cholesteatoma, 30 cases were non-cholesteatoma. The accuracy of TSW-DWI sequence in the diagnosis of cholesteatoma was 89.47%, 3 cases were false negative and 5 cases was false positive. The sensitivity, specificity, positive predictive value and negative predictive value of TSE-DWI in the diagnosis of temporal bone cholesteatoma were 89.13%, 90.00%, 93.18%, and 84.38%, respectively. Conclusion:The TSE-DWI sequence has high signal-to-noise ratio and can improve the diagnostic accuracy and specificity. TSE-DWI sequence is of great value in clinical diagnosis and treatment.


Assuntos
Colesteatoma da Orelha Média/diagnóstico por imagem , Osso Temporal/patologia , Imagem de Difusão por Ressonância Magnética , Humanos , Estudos Prospectivos , Sensibilidade e Especificidade , Osso Temporal/diagnóstico por imagem
5.
Eur. j. anat ; 24(1): 31-35, ene. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-186062

RESUMO

The foramen tympanicum, also known as the foramen of Huschke (FH), is a permanent anatomical variation situated in the anteroinferior section of the external auditory canal, posteromedial to the temporomandibular joint. The aim of the study is to determine the prevalence of the FH in Cleft Lip and Palate (CL/P) patients, compared to healthy individuals by using Cone Beam Computed Tomography (CBCT) data. We retrospectively analyzed the CBCT images of 272 individuals, who had been referred to our Oral and Maxillofacial Radiology clinic various reasons. For comparison, 226 randomly selected healthy individuals and 46 CL/P patients (35 unilateral and 11 bilateral) were evaluated. FH in 35 (12.9%) of the 272 individuals; 26 of them healthy individuals, 9 of them CL/P patients. The FH was higher in patients with CL/P (19.6%) than healthy individuals (11.5%). Clinicians should be aware of the variability of TME and especially the FH in the ear region when radiographically examining these sites prior to CL/P surgery to prevent postoperative reconstruction and complications. Moreover, to evaluate these anatomical variations, CBCT


No disponible


Assuntos
Humanos , Fenda Labial/diagnóstico por imagem , Palato/diagnóstico por imagem , Variação Anatômica , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Palato/anatomia & histologia , Estudos Retrospectivos , Osso Temporal/anatomia & histologia , Tomografia Computadorizada de Feixe Cônico/instrumentação
6.
Radiol Med ; 125(1): 75-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31541345

RESUMO

BACKGROUND AND PURPOSE: The aim of the present prospective study was to verify the specificity of non-EPI DWI-MRI in patients operated for middle ear CHO who showed positivity at imaging performed 6 to 9 months after surgery and underwent second-look surgery. MATERIALS AND METHODS: All patients underwent 1.5-T non-EPI DWI-MRI 6 to 9 months after surgery: those showing a hyper-intense signal in the middle ear underwent a revision surgery, whilst the others are still under radiological follow-up and were not considered in this study. Two radiologists independently evaluated the images; both placed a standard region of interest inside the brightest part of the observed signal alteration on coronal HASTE-DWI images. The mean and maximum signal intensity values on the DWI images were recorded for each patient. A signal intensity ratio was calculated using the inferior temporal cortex and the background noise. RESULTS: One hundred and forty-three subjects were evaluated for a total of 210 ears. In 116 (170 ears), a normal non-EPI DWI-MRI was found with exclusion from this study, whilst twenty-seven subjects showed a high signal lesion inside the middle ear and underwent revision surgery. According to the ROC analysis, SI, SIRT and SIRTmax showed the best statistical values in comparison with the other parameters. CONCLUSIONS: Residual/recurrent CHO can be accurately detected using quantitative evaluation of non-EPI DWI-MRI.


Assuntos
Colesteatoma da Orelha Média/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Osso Temporal/diagnóstico por imagem , Adolescente , Adulto , Criança , Colesteatoma da Orelha Média/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Curva ROC , Recidiva , Reoperação , Sensibilidade e Especificidade , Osso Temporal/cirurgia , Adulto Jovem
7.
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 451-454, Out.-Dez. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1024494

RESUMO

Introduction: The anatomy of the temporal bone is complex due to the large number of structures and functions grouped in this small bone space, which do not exist in any other region in the human body. With the difficulty of obtaining anatomical parts and the increasing number of ear, nose and throat (ENT) doctors, there was a need to create alternatives as real as possible for training otologic surgeons. Objective: Developing a technique to produce temporal bone models that allow them to maintain the external and internal anatomical features faithful to the natural bone. Methods: For this study, we used a computed tomography (CT) scan of the temporal bones of a 30-year-old male patient, with no structural morphological changes or any other pathology detected in the examination, which was later sent to a 3D printer in order to produce a temporal bone biomodel. Results: After dissection, the lead author evaluated the plasticity of the part and its similarity in drilling a natural bone as grade "4" on a scale of 0 to 5, in which 5 is the closest to the natural bone and 0 the farthest from the natural bone. All structures proposed in the method were found with the proposed color. Conclusion: It is concluded that it is feasible to use biomodels in surgical training of specialist doctors. After dissection of the bone biomodel, it was possible to find the anatomical structures proposed, and to reproduce the surgical approaches most used in surgical practice and training implants (AU)


Assuntos
Humanos , Masculino , Adulto , Osso Temporal/cirurgia , Simulação por Computador , Impressão Tridimensional , Modelos Anatômicos , Procedimentos Cirúrgicos Otológicos/métodos , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Educação Médica , Treinamento por Simulação
8.
Radiologe ; 59(12): 1058-1063, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31705161

RESUMO

CLINICAL METHOD: The complexity of the anatomy of the petrous portion of the temporal bone with the crossing nerval, vascular, and muscular structures together with the important parts of the human vestibulocochlear organ poses challenges in clinical routine, especially in the preoperative diagnostic workup. In particular, the presence of standard anatomical variations bears a higher risk of intraoperative injuries. STANDARD RADIOLOGICAL METHOD: MRI and CT examinations are important image-based diagnostic methods in the detection of neoplastic, traumatic and inflammatory lesions of the petrous part of the temporal bone. These kinds of methods are absolutely necessary for the identification of the entity of the lesion, the extent of the infiltration, possible bone involvement or the presence of standard anatomical variations.


Assuntos
Orelha Interna , Imagem por Ressonância Magnética , Osso Temporal , Tomografia Computadorizada por Raios X , Orelha Interna/anatomia & histologia , Orelha Interna/diagnóstico por imagem , Humanos , Osso Petroso/anatomia & histologia , Osso Petroso/diagnóstico por imagem , Osso Temporal/anatomia & histologia , Osso Temporal/diagnóstico por imagem
9.
J Craniofac Surg ; 30(8): e775-e776, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31592840

RESUMO

The aim of this work is to illustrate a transoral mini-invasive approach to safely remove elongated styloid process in Eagle syndrome. A 34-year-old Asian male came to our center referring pharyngeal and cervical pain on the right side on swallowing and opening the mouth. Computed tomography showed elongation of the right styloid process. Surgical removal was performed through endoscopy-assisted intraoral approach using a pituitary curette to perform dissection and piezosurgery for the osteotomy. Surgical intervention was completed in 25 minutes. Postoperative period was uneventful except for transient (12 hours) right facial palsy that resolved spontaneously. Two months after surgery, patient referred resolution of symptoms. This technique is easy to perform and permits to obtain good result with reduction of surgical time and with low risk of complication.


Assuntos
Ossificação Heterotópica/cirurgia , Osso Temporal/anormalidades , Adulto , Humanos , Masculino , Cervicalgia/etiologia , Neuroendoscopia , Ossificação Heterotópica/diagnóstico por imagem , Osteotomia , Piezocirurgia , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia , Tomografia Computadorizada por Raios X
12.
Otolaryngol Head Neck Surg ; 161(5): 842-845, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31547788

RESUMO

OBJECTIVES: To determine the accuracy of a modern navigation system in temporal bone surgery. While routine in other specialties, navigation has had limited use in the temporal bone due to issues of accuracy, perceived impracticality, and value. STUDY DESIGN: Prospective observational study. SETTING: Temporal bone laboratory. SUBJECTS AND METHODS: Eighteen cadaveric specimens were dissected after rigid fiducials were implanted and computed tomography scans were obtained. Target registration and target localization errors were then measured at various points. RESULTS: The mean overall target registration error was 0.48 ± 0.29 mm. The mean target localization error was 0.54 mm at the sinodural angle, 0.48 mm at the lateral semicircular canal, 0.55 mm at the round window, 0.39 mm at the oval window, and 0.52 mm at the second genu of the facial nerve. CONCLUSION: A modern navigation system demonstrated submillimeter accuracy for all points of interest. Its use in clinical as well as training settings has yet to be fully elucidated.


Assuntos
Procedimentos Cirúrgicos Otológicos , Cirurgia Assistida por Computador , Osso Temporal/cirurgia , Cadáver , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
14.
J Stroke Cerebrovasc Dis ; 28(10): 104307, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31383620

RESUMO

Carotid artery dissection is a significant etiology of juvenile stroke. Blunt trauma from an elongated styloid process can rarely cause carotid artery dissection, which is one of well-known clinical presentations of Eagle's syndrome as known as stylocarotid syndrome. Growing number of publications contributed improved awareness and diagnostic modalities for this clinical entity, thus the carotid artery dissection from an elongated styloid process is often diagnosed appropriately. The management of carotid artery dissection in stylocarotid syndrome tends to be nonconservative (ie, removal of the process or carotid stenting) presumably due to a publication bias prone to surgical intervention. However, the compression of elongated styloid process to carotid artery is usually difficult or even dangerous to directly prove. Furthermore, stent fracture with subsequent stent and carotid artery occlusion has been reported as a complication of the treatment. Here, we report a male presenting with acute embolic stroke due to carotid artery dissection with the ipsilateral elongated styloid process who has been managed conservatively for more than 1.5 years without any sequelae. We will discuss the management strategy and emphasize the importance of patient education of daily life, since the surgical intervention seems not always necessary in this clinical setting.


Assuntos
Dissecação da Artéria Carótida Interna/terapia , Artéria Carótida Interna , Tratamento Conservador , Ossificação Heterotópica/terapia , Acidente Vascular Cerebral/terapia , Osso Temporal/anormalidades , Artéria Carótida Interna/diagnóstico por imagem , Dissecação da Artéria Carótida Interna/diagnóstico por imagem , Dissecação da Artéria Carótida Interna/etiologia , Terapia Combinada , Movimentos da Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/complicações , Ossificação Heterotópica/diagnóstico por imagem , Educação de Pacientes como Assunto , Postura , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Osso Temporal/diagnóstico por imagem , Torção Mecânica , Resultado do Tratamento
15.
BMC Med Imaging ; 19(1): 60, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370785

RESUMO

BACKGROUND: Central skull-base osteomyelitis (CSBO) represents a life-threatening complication of external ear canal infection. Computed tomography (CT) and magnetic resonance imaging (MRI) play key roles in assessment of CSBO progression. METHODS: Twelve patients with CSBO were included in a retrospective clinical study. In total, 62 scans (30 CTs and 32 MRIs) were performed to evaluate the extent of inflammatory changes. The scans were read independently by two radiologists specialised in imaging of the head and neck. The regions under the skull base were specified using the online Anatomy Atlas of the skull base. To clarify the timeline, the time period was divided into four parts, and inflammatory changes in the skull-base regions were tracked. Data were statistically analysed. RESULTS: In early stages of the disease, CT scan detects inflammatory changes closely related to the stylomastoid foramen and medially to the posterior belly of the digastric muscle, changes which have been proved to be crucial for the diagnosis of CSBO. Later the infection spreads to the contralateral side causing demineralisation of the bones. CONCLUSION: Imaging methods play a crucial role not only in establishing the diagnosis, but also in anticipating the direction of infection spread underneath the skull base.


Assuntos
Infecções Bacterianas/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Osteomielite/diagnóstico por imagem , Base do Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Bactérias/isolamento & purificação , Progressão da Doença , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Osteomielite/microbiologia , Análise de Regressão , Estudos Retrospectivos , Sensibilidade e Especificidade , Base do Crânio/microbiologia , Osso Temporal/diagnóstico por imagem
16.
Orv Hetil ; 160(24): 936-943, 2019 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-31433232

RESUMO

Introduction: Early cochlear implantation enables prelingual deaf individuals to become full members of the hearing society. Although early diagnostics are widely accessible and enable early rehabilitation, implant surgery often may be delayed due to a candidate's young age. Aim: The authors' objectives were to determine the anatomical parameters of the pediatric and adult temporal bone that are relevant to cochlear implantation and to ascertain the differences between them in order to assess whether the anatomical differences could influence the surgical technique and the timing of surgery. Method: Along with a survey of the literature, findings from the authors own cochlear implantees were assessed with respect to the most relevant dimensions of the internal electronic package, including the stimulating electrode of the cochlear implant, by measuring the squama of the temporal bone, the mastoid cavity and the facial recess on high resolution computed tomographic images. Results: The skull and the overlying soft tissues proved to be thinner and the mastoid cavity was less developed in children than in adults, while no significant changes were noted in the size of the facial recess. Conclusions: It is recommended to choose modern, thin implants that do not require sinking the implant package into a bone bed. Less bone work in infants and children enables excellent visualization of the round window through the underdeveloped mastoid cavity, which makes the procedure less time-consuming and minimally invasive. Indeed, a young age should alert ear surgeons to be cautious, but no higher risk of injury to important structures is predicted for young subjects than those that might occur in adults. Orv Hetil. 2019; 160(24): 936-943.


Assuntos
Implante Coclear/métodos , Implantes Cocleares , Janela da Cóclea/anatomia & histologia , Janela da Cóclea/cirurgia , Osso Temporal/anatomia & histologia , Osso Temporal/cirurgia , Pré-Escolar , Humanos , Lactente , Janela da Cóclea/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
17.
BMC Med Genet ; 20(1): 127, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315586

RESUMO

BACKGROUND: CHARGE syndrome (MIM# 214800)-which is characterised by a number of congenital anomalies including coloboma, ear anomalies, deafness, facial anomalies, heart defects, atresia choanae, genital hypoplasia, growth retardation, and developmental delay-is caused by a heterozygous variant in the CHD7 (MIM# 608892) gene located on chromosome 8q12. We report the identification of a novel c.5535-1G > A variant in CHD7 and provide the evaluation of its effect on pre-mRNA splicing. CASE PRESENTATION: In this study, we report on a female presenting features of CHARGE syndrome. A novel heterozygous CHD7 variant c.5535-1G > A located in the acceptor splice site of intron 26 was identified in the proband's DNA sample after analysis of whole exome sequencing data. In silico predictions indicating that the variant is probably pathogenic by affecting pre-mRNA splicing were verified by genetic analysis based on reverse transcription of the patient's RNA followed by PCR amplifications performed on synthesised cDNA and Sanger sequencing. Sanger sequencing of cDNA revealed that the c.5535-1G > A variant disrupts the original acceptor splice site and activates a cryptic splice site only one nucleotide downstream of the pathogenic variant site. This change causes the omission of the first nucleotide of exon 27, leading to a frameshift in the mRNA of the CHD7 gene. Our results suggest that the alteration induces the premature truncation of the CHD7 protein (UniProtKB: Q9P2D1), thus resulting in CHARGE syndrome. CONCLUSION: Genetic analysis of novel splice site variant underlines its importance for studying the pathogenic splicing mechanism as well as for confirming a diagnosis.


Assuntos
Síndrome CHARGE/genética , DNA Helicases/genética , Proteínas de Ligação a DNA/genética , Predisposição Genética para Doença/genética , Sítios de Splice de RNA , Adolescente , Sequência de Aminoácidos , Sequência de Bases , Síndrome CHARGE/diagnóstico por imagem , Síndrome CHARGE/fisiopatologia , Feminino , Mutação da Fase de Leitura , Estudos de Associação Genética , Heterozigoto , Humanos , Íntrons , Mutação , Processamento de RNA , RNA Mensageiro , Alinhamento de Sequência , Osso Temporal/diagnóstico por imagem , Sequenciamento Completo do Exoma
18.
BMJ Case Rep ; 12(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31320373

RESUMO

A 67-year-old woman was referred to the otolaryngology service after presenting to the emergency department for dizziness and loss of balance. She reported several similar episodes over the past years. Physical examination was unremarkable. A temporal bone CT scan revealed dehiscence between the bony carotid canal and the cochlea resulting in the diagnosis of carotid-cochlear dehiscence (CCD). CCD is an extremely rare condition involving the thinning of the bony canal separating the internal carotid artery from the cochlea. CCD is best diagnosed with temporal bone CT scan. Treatment options include observation as well as chemical or surgical labyrenthectomy. Despite similar clinical and diagnostic characteristics of reported CCD cases, general trends and consensus on treatment options cannot be ascertained due to the extreme rarity of this condition. Regardless of these limitations, CCD is a critical diagnosis as it mimics other inner ear conditions and poses a potential, significant surgical risk for the otolaryngologist.


Assuntos
Artéria Carótida Interna/diagnóstico por imagem , Doenças Cocleares/diagnóstico por imagem , Doenças do Labirinto/diagnóstico , Osso Temporal/diagnóstico por imagem , Testes de Impedância Acústica , Idoso , Audiometria de Tons Puros , Doenças Cocleares/complicações , Doenças Cocleares/fisiopatologia , Diagnóstico Diferencial , Feminino , Perda Auditiva Neurossensorial/etiologia , Humanos , Teste do Limiar de Recepção da Fala , Zumbido/etiologia , Tomografia Computadorizada por Raios X , Vertigem/etiologia
19.
J Int Adv Otol ; 15(2): 330-332, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31287431

RESUMO

Facial nerve schwannomas are rare benign neoplasms. We report a case of a 60-year-old woman who initially presented with vestibular complaints. Magnetic resonance imaging (MRI) revealed a facial nerve schwannoma centered on the right geniculate ganglion extending in the labyrinthine segment. The patient consulted again after 2 months because she developed a sudden and severe right-sided sensorineural hearing loss. MRI showed no progression or pathological enhancement in the membranous labyrinth. A cone beam computed tomography (CT) of the temporal bone was performed and revealed a large erosion at the region of the geniculate ganglion in open communication with the middle turn of the cochlea. This case report demonstrates the importance of CT in facial nerve schwannomas for evaluating the impact on the surrounding structures.


Assuntos
Doenças Cocleares/etiologia , Neoplasias dos Nervos Cranianos/complicações , Doenças do Nervo Facial/complicações , Neurilemoma/complicações , Doenças Cocleares/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Doenças do Nervo Facial/diagnóstico por imagem , Feminino , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/etiologia , Humanos , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem
20.
Ann Otol Rhinol Laryngol ; 128(11): 1054-1060, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31288548

RESUMO

OBJECTIVES: To present a systematic checklist to improve diagnosing otosclerosis (OS) on high-resolution computed tomography (HRCT) of the temporal bones and review this protocol's efficacy in diagnosing OS on HRCT. METHODS: A retrospective case series was performed at a University Referral Hospital in urban Chicago, Illinois. High-resolution computed tomographies of the temporal bone were reviewed including 17 ears in the test group with surgically confirmed OS and 21 ears in the control group surgically confirmed to not have OS. Preoperative HRCTs were evaluated by a single neuroradiologist using a systematic protocol created to assist in diagnosing OS. This looked for radiolucency at the fissula ante fenestram and pericochlear region, and new bone formation around the oval and round windows. RESULTS: The radiologist accurately diagnosed OS in all 17 test group ears and ruled out OS in all 21 control group ears using the protocol. All 17 test ears were read to have lucency at the fissula ante fenestram, 9 (53.0%) to have new bone formation, and 8 (47.1%) to have cochlear lucency. The radiologist was more confident in diagnosing OS when cochlear lucency was present with the fissula ante fenestram lucency. CONCLUSIONS: This HRCT checklist is a highly accurate tool for evaluating the presence of OS when images are reviewed in the systematic fashion described. Imaging prior to surgery aids in counseling patients, preparing surgically, and excluding other pathologies.


Assuntos
Cóclea/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Otosclerose/diagnóstico , Osso Temporal/diagnóstico por imagem , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Otosclerose/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Cirurgia do Estribo/métodos
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