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Physical Recovery
Published in Stijn Geerinck, Reconstructing Identity After Brain Injury, 2022
Partial paralysis of my body prevented me from closing my left eye. This didn’t get any better, contrary to my arm and leg. I continuously had to use eye-drops and to apply ointment before going to sleep. My right eye socket was shattered and had been removed, which made my eye sink away into my face. My left ear was beyond the help of even a hearing aid. It had lost its function to a fracture of the petrous part of the temporal bone and to a severely damaged cochlea. They only broke the news to me 14 months after the accident. From now on, I had to make do with my right ear, so I wanted extra protection. I ordered custom earplugs to continue to play music and do my job as a teacher, afraid of losing my hearing entirely.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
There are a number of clinical signs I would examine for in this particular patient. Upon inspection, I would look around the eyes for the ‘Racoon eye sign’. This is suggestive of periorbital ecchymosis which would result from blood exudation secondary to a basilar skull fracture, particularly in unilateral presentations. I would also inspect the patient's mastoid process for similar signs of ecchymosis. This again can result from blood pooling as a result of basilar skull fractures, and is most often associated with trauma to the petrous part of the temporal bone, which I would palpate for signs of injury. I would move on to examine the ears for signs of bloody otorrhoea, which are also often associated with trauma to the petrous part of the temporal bone. Finally, I would gently palpate around the head for a ‘step off’, or discrepancy, in the bone architecture which would suggest a fracture.
One or Both Optic Discs are Swollen
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Diplopia: Motility deficits may be seen as a false localising sign in patients with raised ICP due to involvement of unilateral and/or bilateral abducens (sixth) nerve palsy. This is due to stretching of sixth cranial nerve over the petrous part of the temporal bone. The incidence of a sixth cranial nerve palsy in patients with IIH is around 38%. Patients usually report a horizontal diplopia. Third and fourth cranial nerve palsies, although not common, can also be present in IIH.
Ciliated cell observation by SEM on the surface of human incudo-malleolar-joint articular cartilage: are they a new chondrocyte phenotype?
Published in Acta Oto-Laryngologica, 2019
Michela Relucenti, Selenia Miglietta, Edoardo Covelli, Pietro Familiari, Ezio Battaglione, Giuseppe Familiari, Maurizio Barbara
The middle ear cavity is a bony space in the petrous part of the temporal bone where the ossicular chain (malleus, incus, stapes) is also accommodated. It communicates with the nasopharynx via the Eustachian tube and with the mastoid air–cell complex via the antrum cell. In addition, the mucosa lining the tympanic cavity, consisting in a flattened squamous epithelium with a thin lamina propria, closely adherent to the underlying bone, is in continuation with those of the Eustachian tube and of the mastoid air cells. This mucosal lining envelops the ossicular chain, including the incus, the middle component of the ossicular chain which articulates with the malleus by means of a saddle joint containing an intra-articular disc. The human incudo-malleolar joint is a non-weight-bearing joint described in detail by Gussen [1] and Stockwell [2] using light microscopy.
Clinical characteristics of petrosal cholesteatoma and value of MRI-DWI in the diagnosis
Published in Acta Oto-Laryngologica, 2020
Wenjing Zuo, Fangyuan Wang, Shiming Yang, Dongyi Han, Pu Dai, Weidong Shen, Zhaohui Hou, Weiju Han
Petrous cholesteatoma of the temporal bone refers to cholesteatoma caused by various causes that invades the petrous part of the temporal bone and reaches the medial range of the inner ear. It was rare in the past, but now the incidence rate is higher than before [11]. Because of its deep location and lack of specific clinical symptoms, it is not easy to get an early diagnosis. And it is adjacent to important structures, such as internal carotid artery, facial nerve, labyrinth, sigmoid sinus, jugular bulb, posterior and middle fossa dura mater, posterior cranial nerves and etc [12]. Cholesteatoma is divided into congenital cholesteatoma and acquired cholesteatoma. Congenital cholesteatoma is the development of embryonic ectodermal tissue in the skull. The pathological features are squamous epithelium and keratocytes which gathered in the middle ear mastoid cavity, petroclival apex or cerebellopontine angle. Although it is a benign lesion, it can also destroy the normal structure of the surrounding area and cause serious complications, even death. At present, the exact incidence, etiology and pathogenesis of the disease are not clear [13]. The pathological features of acquired cholesteatoma of middle ear are mainly as follows: the lamellar squamous epithelium invades the middle ear cavity, forms the capsule bag, and abnormal proliferates, which results in the excessive keratosis of the squamous epithelium falling off and accumulating, gradually expanding and involving the surrounding tissues and structures. It can cause serious bone resorption damage and leading to hearing loss, vertigo, tinnitus, hemifacial spasm, facial paralysis, diplopia, ear leakage, and even threaten the lives of patients [1].
Foramen caecum medullae oblongatae in the history of anatomical terminology
Published in Journal of the History of the Neurosciences, 2020
František Šimon, Florian Steger
The term foramen caecum itself was used several times in different ways within anatomical terminology, meaning not only an extension of the spinal cord but also the frontal bone (foramen caecum ossis frontalis) and the tongue (foramen caecum linguae) and it did, in fact, occur in anatomical terminology prior to Soemmerring. According to Galen (See Galenos 1821, II 838 K., and Mayo 1966, 330) the ancient anatomists called the hollow in the petrous part of the temporal bone (today foramen stylomastoideum) tyflon (i.e. caecum), because they were “not able to perfectly bore out the helix through which the facial nerve penetrates to the exterior behind the external ear.”