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1.
J Laryngol Otol ; 135(2): 134-141, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33536091

RESUMO

OBJECTIVE: This paper describes the construction of portals for electrode placement during cochlear implantation and emphasises the utility of pre-operative temporal bone three-dimensional computed tomography. METHODS: Temporal bone three-dimensional computed tomography was used to plan portal creation for electrode insertion. RESULTS: Pre-operative temporal bone three-dimensional computed tomography can be used to determine the orientation of temporal bone structures, which is important for mastoidectomy, posterior tympanotomy and cochleostomy, and when using the round window approach. CONCLUSION: It is essential to create appropriate portals (from the mastoid cortex to the cochlea) in a step-by-step manner, to ensure the safe insertion of electrodes into the scala tympani. Pre-operative three-dimensional temporal bone computed tomography is invaluable in this respect.


Assuntos
Implante Coclear/métodos , Eletrodos Implantados/efeitos adversos , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Cóclea/cirurgia , Implante Coclear/efeitos adversos , Eletrodos Implantados/normas , Humanos , Doença Iatrogênica/prevenção & controle , Imageamento Tridimensional/métodos , Mastoidectomia/métodos , Ventilação da Orelha Média/métodos , Período Pré-Operatório , Janela da Cóclea/cirurgia , Rampa do Tímpano/cirurgia , Osso Temporal/cirurgia
2.
Laryngorhinootologie ; 100(2): 99-103, 2021 02.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-33525009

RESUMO

Inverted papilloma of middle ear is an extremely rare lesion of the respiratory epithelium that normally occurs in the nasal cavity and paranasal sinuses. So far less than 17 cases were described in literature. A 45-year-old patient was admitted in our Department with hearing loss, otorrhea and pulsing tinnitus on the right ear. The clinical examination showed a granulation tissue on the right eardrum. No tumor formation was seen in the nasal cavity. The MRI showed a tissue formation in the tympanic cavity with an extension in the middle cranial fossa. A mastoidectomy with antrotomy and duraplasty was performed. The histological diagnosis was inverted papilloma of the middle ear. In a second step occurred an eradication of the tumor with a subtotal petrosectomy. The etiology of the inverted papilloma of the middle ear is unknown. Our case is so far the 18nd case described.Our experience has shown that the eradication of the tumor with a subtotal petrosectomy resulted as reasonable procedure. A long-term follow-up is suggested in order to detect possible recurrence or malignant transformation.


Assuntos
Neoplasias da Orelha , Papiloma Invertido , Neoplasias dos Seios Paranasais , Orelha Média/diagnóstico por imagem , Orelha Média/cirurgia , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Papiloma Invertido/cirurgia , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia
3.
Artigo em Chinês | MEDLINE | ID: mdl-33540965

RESUMO

Objective:To report a new CT measurement to predict the exposure of round window niche during facial nerve recess surgery. Methods:Forty CT scans were measured by conventional facial-round window line and limiting facial-round window line method, and compared with the exposure of round window niche after the opening of the facial recess. Results:There was no significant difference in the sensitivity and specificity of the two CT measurement methods to predict the exposure degree of the round window niche, and the Kappa consistency test of the two methods also showed a strong correlation. Conclusion:The new measurement method can predict the exposure of the round window niche pre-operation, and in practice, it can predict the maximum exposure of the round window niche.


Assuntos
Implante Coclear , Nervo Facial , Nervo Facial/diagnóstico por imagem , Humanos , Janela da Cóclea/cirurgia , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia , Tomografia Computadorizada por Raios X
4.
AJNR Am J Neuroradiol ; 42(2): 362-367, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33414229

RESUMO

BACKGROUND AND PURPOSE: Cone-beam CT is being increasingly used in head and neck imaging. We compared cone-beam CT with multidetector CT to assess postoperative implant placement and delineate finer anatomic structures, image quality, and radiation dose used. MATERIALS AND METHODS: This retrospective multicenter study included 51 patients with cochlear implants and postoperative imaging via temporal bone cone-beam CT (n = 32 ears) or multidetector CT (n = 19 ears) between 2012 and 2017. We evaluated the visualization quality of single electrode contacts, the scalar position of the electrodes, cochlear walls, mastoid facial canal, metallic artifacts (using a 4-level visual score), and the ability to measure the insertion angle of the electrodes. The signal-to-noise ratio and radiation dose were also evaluated. RESULTS: Cone-beam CT was more sensitive for visualizing the scalar position of the electrodes (P = .046), cochlear outer wall (P = .001), single electrode contacts (P < .001), and osseous spiral lamina (P = .004) and had fewer metallic artifacts (P < .001). However, there were no significant differences between both methods in visualization of the modiolus (P = .37), cochlear inner wall (P > .99), and mastoid facial canal wall (P = .07) and the ability to measure the insertion angle of the electrodes (P > .99). The conebeam CT group had significantly lower dose-length product (P < .001), but multidetector CT showed a higher signal-to-noise ratio in both bone and air (P = .22 and P = .001). CONCLUSIONS: Cone-beam CT in patients with cochlear implants provides images with higher spatial resolution and fewer metallic artifacts than multidetector CT at a relatively lower radiation dose.


Assuntos
Cóclea/diagnóstico por imagem , Implante Coclear , Implantes Cocleares , Tomografia Computadorizada de Feixe Cônico/métodos , Tomografia Computadorizada Multidetectores/métodos , Adulto , Cóclea/cirurgia , Implante Coclear/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Osso Temporal/diagnóstico por imagem
5.
AJR Am J Roentgenol ; 216(3): 752-758, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33439050

RESUMO

OBJECTIVE. The purpose of this article is to evaluate subjective image quality and diagnostic accuracy to determine cochlear implant (CI) electrode position in a temporal bone (TB) specimen on cone-beam CT (CBCT) versus MDCT. MATERIALS AND METHODS. In this retrospective study, two radiologists independently reviewed CBCT (96-kV and 120-kV settings) and MDCT images of 20 TB specimens after electrode implantation. Qualitative evaluation of bone structures of the otic capsule, inner and outer cochlear wall, osseous spiral lamina, electrode position relative to the osseous spiral lamina, visualization of single electrode contacts on the array, metal artifacts, and overall image quality was performed using a five-point scale. Intracochlear electrode position was subsequently correlated with histologic examination. RESULTS. Radiologic assessment of bone structures of the otic capsule, the cochlear wall (except the outer part), osseous spiral lamina, electrode position, visualization of single electrode contacts on the array, metal artifacts, and overall image quality were significantly higher in CBCT compared with MDCT (maximum p = .04). No significant differences were found between CBCT at 96 kV and 120 kV (minimum p = .21). The intracochlear electrode position with histologic correlation was correctly diagnosed in 100% and 97.5% of specimens on 120-kV and 96-kV CBCT, respectively, whereas 77.5% were correctly assessed using MDCT. CONCLUSION. The data suggest that CBCT shows a higher diagnostic accuracy in TB specimen imaging after CI compared with MDCT, in particular to determine the intracochlear localization of the implant.


Assuntos
Implante Coclear , Implantes Cocleares , Tomografia Computadorizada de Feixe Cônico , Tomografia Computadorizada Multidetectores , Osso Temporal/diagnóstico por imagem , Humanos , Doses de Radiação , Estudos Retrospectivos
6.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461995

RESUMO

We report a child, diagnosed with Coffin-Siris syndrome (CSS), with chronic right otorrhoea. CT and DR-MRI were performed to further investigate, diagnose and determine relevant surgical anatomy. CT temporal bones assessment was performed, and the measurements compared with previously published data for normal temporal bone anatomy. These comparisons highlighted various differences which were not initially expected; it showed that there were multiple inner ear abnormalities in addition to middle ear disease. This case highlights the importance of considering temporal bone abnormalities in all children with CSS or any dysmorphia, when they may require mastoid procedures. Reviewing the management of this case provides relevant learning opportunities for both primary, secondary and tertiary care institutions.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Doenças do Desenvolvimento Ósseo/etiologia , Face/anormalidades , Deformidades Congênitas da Mão/diagnóstico por imagem , Deficiência Intelectual/diagnóstico por imagem , Imagem por Ressonância Magnética , Micrognatismo/diagnóstico por imagem , Pescoço/anormalidades , Osso Temporal/anormalidades , Tomografia Computadorizada por Raios X , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Criança , Face/diagnóstico por imagem , Deformidades Congênitas da Mão/complicações , Humanos , Deficiência Intelectual/complicações , Masculino , Micrognatismo/complicações , Pescoço/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem
7.
Vestn Otorinolaringol ; 85(5): 44-50, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140933

RESUMO

TO STUDY: The effect of the elemental composition of bone tissue on the destruction of the structures of the temporal bone in chronic suppurative otitis media. PATIENTS AND METHODS: The study included 331 patients aged 16-75 years with a verified diagnosis of chronic purulent otitis media, subject to surgical treatment. Depending on the diagnosis and method of surgical treatment, patients are divided into groups: patients with tubotympanic otitis media and epitympanic-antral otitis media after reconstructive sanitation otosurgery in comparison with the control group. The elemental composition of the bone tissue of the cavities of the middle ear obtained intraoperatively was evaluated by x-ray fluorescence spectroscopy. Elements in the bone tissue of the cavities of the middle ear obtained intraoperatively were evaluated by spectrophotometric method. The data are processed by descriptive statistics methods and are presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. RESULTS: A comparison of the indicators characterizing the elemental composition of the temporal bone tissue in patients with forms of chronic otitis media demonstrates the progression of the severity of pathological bone remodeling according to various options. In the dynamics of observation in patients with morphological signs of purulent destruction of the structures of the temporal bone, not only the most profound imbalance in the levels of calcium and phosphorus was revealed, but also the limitation of the levels of silicon and sulfur in a progressive and recurrent course at different periods of the disease. CONCLUSION: X-ray fluorescence spectroscopy allows an elemental chemical analysis of bone remodeling according to the pathological type and reliably differentiate purulent diseases of the temporal bone. The results are promising from the point of view of developing new prognostic approaches in otosurgery in the management of patients with chronic purulent otitis media, involving the combined use of morphological research methods with microelement analysis of the temporal bone bone tissue.


Assuntos
Otite Média Supurativa , Otite Média , Adolescente , Adulto , Idoso , Doença Crônica , Orelha Média/diagnóstico por imagem , Orelha Média/cirurgia , Humanos , Pessoa de Meia-Idade , Otite Média Supurativa/diagnóstico , Otite Média Supurativa/cirurgia , Reprodutibilidade dos Testes , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia , Adulto Jovem
8.
Vestn Otorinolaringol ; 85(5): 103-105, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140945

RESUMO

The article describes the clinical case of the cholesteatoma of the temporal bone pyramid, leading to a massive destruction of the surrounding structures. Attention is drawn to the importance of timely diagnosis of this pathology with the use of objective visualization methods to select the optimal surgical approach, which allows to completely remove this formation.


Assuntos
Colesteatoma da Orelha Média , Colesteatoma , Otite Média Supurativa , Colesteatoma/diagnóstico , Colesteatoma/cirurgia , Colesteatoma da Orelha Média/diagnóstico , Colesteatoma da Orelha Média/cirurgia , Doença Crônica , Humanos , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia
10.
J Laryngol Otol ; 134(8): 721-726, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32787992

RESUMO

OBJECTIVE: Bibliographic data for the management of acute mastoiditis in infants aged six months or less are very limited. This study investigated the presenting symptomatology, diagnostic and treatment options, and final outcomes in this age group. METHOD: A retrospective review was conducted of all infants aged six months or less suffering from acute mastoiditis, admitted to our department between 2007 and 2017. RESULTS: Eleven infants were identified. All of them developed the typical symptomatology of acute mastoiditis, while a higher rate of subperiosteal abscess formation was observed. Imaging was necessary in three cases only. Parenteral antibiotics and myringotomy were applied in all infants. A drainage procedure was also included in the infants with a subperiosteal abscess. Antrotomy was reserved for non-responsive cases. No intracranial complications were observed. All infants were cured without further complications or sequelae. CONCLUSION: Acute mastoiditis in infants aged six months or less can be safely diagnosed and treated using a standardised algorithmic approach, similar to that used for older children.


Assuntos
Mastoidite/diagnóstico , Mastoidite/terapia , Periósteo/microbiologia , Abscesso/cirurgia , Doença Aguda , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Drenagem/métodos , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Mastoidite/complicações , Mastoidite/epidemiologia , Ventilação da Orelha Média/métodos , Otite Média , Estudos Retrospectivos , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
11.
J Craniomaxillofac Surg ; 48(10): 1009-1017, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32811716

RESUMO

AIM OF STUDY: a retrospective study was done to assess symptoms correlated with and responsible for the misdiagnosis of Eagle's syndrome with Cranio-Mandibular Disorders. MATERIALS AND METHODS: Our study comprised patients suffering from vague craniofacial pain resulting from elongated styloid processes, presented to the outpatient clinic of the oral and maxillofacial surgery department, October 6 University Hospital. The length of styloid processes was measured on 3D-CT X-rays. All our patients were operated by surgical treatment in the form of shortening of the styloid process (styloidectomy) under general anaesthesia and followed up clinically as well as radiographically for 12 months. RESULTS: Patients were assessed preoperatively as well as postoperatively throughout the following scheduled regular follow up intervals at 1 week and at 1,3,6 and 12 months postoperatively for the following parameters. VAS pain score gradually decreased from a median of 9, with a minimum of 7 and a maximum of 10 pre-operatively to a median of 1.5, with a minimum of 0 and a maximum of 3 at twelve months. Freidman test revealed a statistically significant difference by time. Maximum unassisted mouth opening was assessed. Mouth opening significantly decreased from 30.23 ± 3.28 pre-operatively to 26.08 ± 2.83 after one week, then gradually increased to reach its highest level (43.56 ± 0.72) at twelve months. CONCLUSION: When dealing with cases of vague craniofacial pain, possibility of Eagle syndrome should be considered.


Assuntos
Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/diagnóstico , Ossificação Heterotópica/cirurgia , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia , Erros de Diagnóstico , Dor Facial/diagnóstico , Dor Facial/etiologia , Humanos , Estudos Retrospectivos , Osso Temporal/anormalidades
12.
J Laryngol Otol ; 134(7): 610-622, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32686623

RESUMO

OBJECTIVE: To depict various temporal bone abnormalities on high-resolution computed tomography in congenital aural atresia patients, and correlate these findings with auditory function test results and microtia subgroup. METHODS: Forty patients (56 ears) with congenital malformation of the auricle and/or external auditory canal were evaluated. Auricles were graded according to Marx's classification, divided into subgroups of minor (grades I and II) and major (III and IV) microtia. Other associated anomalies of the external auditory canal, tympanic cavity, ossicular status, oval and round windows, facial nerve, and inner ear were evaluated. RESULTS: Minor and major microtia were observed in 53.6 and 46.4 per cent of ears respectively. Mean hearing levels were 62.47 and 62.37 dB respectively (p = 0.98). The malleus was the most commonly dysplastic ossicle (73.3 vs 80.8 per cent of ears respectively, p = 0.53). Facial nerve (mastoid segment) abnormalities were associated (p = 0.04) with microtia subgroup (80 vs 100 per cent in minor vs major subgroups). CONCLUSION: Microtia grade was not significantly associated with mean hearing levels or other ear malformations, except for external auditory canal and facial nerve (mastoid segment) anomalies. High-resolution computed tomography is essential in congenital aural atresia, before management strategy is decided.


Assuntos
Anormalidades Congênitas/diagnóstico por imagem , Orelha/anormalidades , Adolescente , Adulto , Criança , Pré-Escolar , Anormalidades Congênitas/diagnóstico , Anormalidades Congênitas/patologia , Microtia Congênita/diagnóstico , Microtia Congênita/diagnóstico por imagem , Estudos Transversais , Orelha/diagnóstico por imagem , Orelha/patologia , Meato Acústico Externo/diagnóstico por imagem , Meato Acústico Externo/patologia , Nervo Facial/diagnóstico por imagem , Nervo Facial/patologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Osso Temporal/diagnóstico por imagem , Osso Temporal/patologia , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
13.
BMC Neurol ; 20(1): 285, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32693780

RESUMO

BACKGROUND: Patients with vascular Ehlers-Danlos syndrome (EDS) occasionally suffer from arterial dissection. Eagle syndrome, which is caused by an elongated styloid process and also causes arterial dissection, is difficult to diagnose and could sometimes be overlooked. Little is known of the coexistence of these two diseases, and treatment strategy is not established. Here, we present a case of bilateral internal carotid artery (ICA) dissection due to Eagle syndrome in a patient with vascular EDS. CASE PRESENTATION: A 30-year-old man was admitted to our hospital because of sudden onset of mild sensory disturbance in his left limbs. He had a history of Ehlers-Danlos syndrome (EDS) and also had left cervical internal carotid artery (ICA) dissection 3 years before. Diffusion-weighted imaging showed acute cerebral infarcts in the right hemisphere. Cervical computed tomography angiography (CTA) revealed the right ICA narrowing at the cervical portion in addition to the previous left cervical ICA dissection. Cervical magnetic resonance imaging (MRI) revealed double-lumen and intramural hematoma at the narrowing portion of the right cervical ICA, which indicates arterial dissection. CT also revealed bilateral elongated styloid processes which are close to each side of cervical ICA. We diagnosed him as bilateral ICA dissection due to bilateral Eagle syndrome. Considering vascular complications due to vascular EDS, we performed closer follow-up with transoral carotid ultrasonography (TOCU). In 4 months, his right ICA dissection gradually improved without stroke recurrence or deterioration of dissection. CONCLUSIONS: Since patients with vascular EDS easily develop arterial dissection, Eagle syndrome may be overlooked. Clinicians should consider Eagle syndrome in the case of vascular EDS with extracranial ICA dissection and close follow-up should be prioritized in cases of Eagle syndrome with vascular EDS.


Assuntos
Dissecação da Artéria Carótida Interna/diagnóstico por imagem , Síndrome de Ehlers-Danlos/diagnóstico por imagem , Ossificação Heterotópica/diagnóstico por imagem , Osso Temporal/anormalidades , Adulto , Dissecação da Artéria Carótida Interna/complicações , Dissecação da Artéria Carótida Interna/etiologia , Estenose das Carótidas/complicações , Angiografia por Tomografia Computadorizada , Imagem de Difusão por Ressonância Magnética , Síndrome de Ehlers-Danlos/complicações , Humanos , Imagem por Ressonância Magnética , Masculino , Ossificação Heterotópica/complicações , Osso Temporal/diagnóstico por imagem , Ultrassonografia
15.
Clin Imaging ; 66: 42-53, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32450482

RESUMO

Ear malformations represent 50% of ear, nose and throat malformations. Ear malformations cause conductive hearing loss (CHL) and/or sensorineural hearing loss (SNHL) with a significant childhood disability worldwide. Early accurate diagnosis and treatment are mandatory to enhance language and speech development. Understanding the embryology of the ear explains the outcome of ototoxic prenatal insult according to the affected gestational age and the incidence of association among inner, middle, and external ear malformations. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations of the temporal bone are used in the evaluation of ear malformations. In this review article, the spectrum of ear malformations is discussed in detail with hints on the ear embryology, the ear radiological anatomy, and radiological determinant factors of operative reconstruction of ear anomalies.


Assuntos
Orelha Interna/anormalidades , Orelha Interna/diagnóstico por imagem , Criança , Feminino , Idade Gestacional , Perda Auditiva Neurossensorial/diagnóstico por imagem , Humanos , Idioma , Imagem por Ressonância Magnética/efeitos adversos , Masculino , Ototoxicidade , Radiografia , Radiologistas , Radiologia , Osso Temporal/anormalidades , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
16.
Int J Comput Assist Radiol Surg ; 15(7): 1137-1145, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32440956

RESUMO

PURPOSE: Accurate estimation of the position and orientation (pose) of surgical instruments is crucial for delicate minimally invasive temporal bone surgery. Current techniques lack in accuracy and/or line-of-sight constraints (conventional tracking systems) or expose the patient to prohibitive ionizing radiation (intra-operative CT). A possible solution is to capture the instrument with a c-arm at irregular intervals and recover the pose from the image. METHODS: i3PosNet infers the position and orientation of instruments from images using a pose estimation network. Said framework considers localized patches and outputs pseudo-landmarks. The pose is reconstructed from pseudo-landmarks by geometric considerations. RESULTS: We show i3PosNet reaches errors [Formula: see text] mm. It outperforms conventional image registration-based approaches reducing average and maximum errors by at least two thirds. i3PosNet trained on synthetic images generalizes to real X-rays without any further adaptation. CONCLUSION: The translation of deep learning-based methods to surgical applications is difficult, because large representative datasets for training and testing are not available. This work empirically shows sub-millimeter pose estimation trained solely based on synthetic training data.


Assuntos
Procedimentos Cirúrgicos Otológicos/métodos , Cirurgia Assistida por Computador/métodos , Osso Temporal/cirurgia , Humanos , Imageamento Tridimensional/métodos , Procedimentos Cirúrgicos Minimamente Invasivos , Radiografia , Osso Temporal/diagnóstico por imagem
18.
Clin Imaging ; 65: 5-7, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32344289

RESUMO

Osteochondromas, the most common benign bone tumor, are typically asymptomatic and discovered incidentally by imaging. Most frequently, osteochondromas occur at the metaphyses of long bones, and rarely involve the head and neck. We report the first case of a symptomatic osteochondroma of the temporal styloid process causing facial nerve paralysis.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteocondroma/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Adulto , Neoplasias Ósseas/patologia , Osso e Ossos/patologia , Cabeça/patologia , Humanos , Masculino , Pescoço/patologia , Osteocondroma/patologia , Neoplasias de Tecidos Moles , Osso Temporal/patologia
19.
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
20.
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
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