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Anatomy and Embryology of the External and Middle Ear
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Ossification of the cartilaginous otic capsule begins in or around week 16 from a variable number of centres that finally fuse without leaving telltale suture lines. This dense bony mass is the petrous bone. Interestingly, this is frequently the last part of a whale to decompose and is sometimes the only remains of those eaten by sharks.
The ear
Published in Rogan J Corbridge, Essential ENT, 2011
Tumours of the facial nerve itself are rare. The nerve, however, can be involved by a tumour anywhere along its course: Parotid gland: VII nerve palsy usually indicates a malignant lesion.External and middle ear: malignant lesions such as squamous cell carcinoma.CPA: acoustic neuroma, glomus tumours, etc.Petrous bone: cysts, secondary carcinomas.
Imaging of the nasopharynx, face and neck
Published in Sarah McWilliams, Practical Radiological Anatomy, 2011
Fig. 2.21 Axial and coronal petrous bone. (a) Axial CT shows the basal turn of the cochlea (1). The incudomalleolar complex in the epitympanic recess (2); aditus or opening to the mastoid air cells (3); vestibule with horizontal semicircular canal (4). (b) Axial T2-weighted MRI: basal turn of cochlea (1). Nerves VII and VIII in internal auditory canal (5). (c) Coronal T2-weighted MRI: cochlea (1), third ventricle (6), basilar artery (7), internal capsule (8) and insula (9). (d) Diagram of the inner and middle ear.
Vestibular schwannoma extending into the tympanic cavity and jugular fossa by invasion of the petrous bone
Published in British Journal of Neurosurgery, 2023
Hideaki Matsumura, Masahide Matsuda, Keiji Tabuchi, Tetsuya Yamamoto, Eiichi Ishikawa, Akira Matsumura
According to the retrospective identification of the high intensity area in the right vestibule on a past MRI 5 years prior, we assume that the tumour originated in the vestibule [4,5]. Due to the lack of dura matter protection around the vestibule in contrast to the internal acoustic meatus, the tumour could easily extend into the petrous bone towards the jugular fossa. This may explain why the tumour first invaded the petrous bone. In our case, over time, the tumour in the vestibule also extended to the fundus of the internal acoustic meatus, and then finally into the cerebellopontine cistern. Although this form of extension was previously reported as transmacular extension [4,5], further aggressive invasion of the petrous bone as in our case is extremely rare. The tumour extended from the vestibule into the internal acoustic meatus without destroying the bony structure around the fundus of the internal acoustic meatus, presumably because the otic capsule is the hardest bone in the entire skeleton [6].
Combined transmastoid/middle fossa approach for a petrous bone cholesteatoma: A case report and literature review
Published in Acta Oto-Laryngologica Case Reports, 2021
Kiyotaka Miyazato, Yohei Hokama, Hideki Nagamine, Akira Ganaha, Mikio Suzuki, Shogo Ishiuchi
A petrous bone cholesteatoma is defined as a cholesteatoma that is congenital in nature and is detached from the tympanic membrane or external auditory meatus. It is a rare pathologic entity with a reported incidence of 4%–9% of all petrous pyramid lesions [1]. Such lesions span from the upper internal auditory meatus to the geniculum of the facial nerve and the petrous bone of the superior semicircular canal. Various approaches can be considered, including the translabyrinthine approach or the middle cranial fossa. Tumors are located in such complex anatomical region that in any surgical approach, radical resection of the tumor with the preservation of VII and VIII nerve function is challenging. To solve this problem, we performed a preoperative three-dimensional (3D) simulation to grasp safe surgical corridors connecting the otological and cranial routes.
Clinical outcomes of different treatments and risk factors in patients with otogenic brain abscess, a real-world evidence-based retrospective study
Published in Acta Oto-Laryngologica, 2020
Yao Song, Danni Cheng, Ke Qiu, Xiaohong Yan, Jianjun Ren, Jianqing Qiu, Di Deng, Yufang Rao, Yongbo Zheng, Wendu Pang, Yijun Dong, Qiurui Liu, Yanming Ren, Yu Zhao
The significant prognostic factors were the invasive range of the cholesteatoma, level of consciousness at admission and the surgical management strategy. Other factors, such as age, sex and lifestyle, as well as abscess volume, number, location and stage, were not associated with increased risk of mortality. Cholesteatoma can be congenital or acquired [12]. The anatomical relationship of the centre of the otic capsule and the petrous bone surrounded by important structures, such as the inner ear, facial nerve, internal carotid artery, dura, temporal lobe and cerebellum, is complex [12]. As cholesteatoma gradually enlarges, it even poses the risk of penetrating the bone and invading the region of the cerebellopontine angle, which will cause symptoms that much more severe [13]. Moreover, the late onset of symptoms involving the ear and the intracranial complications of cholesteatoma in deeper locations may explain the higher mortality of our patients with cholesteatoma of the petrous apex.