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ENT Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Alternatively, a longitudinal fracture of the temporal bone will tear the eardrum and cause dislocation of the ossicular chain, with conductive deafness, haemotympanum and cerebrospinal fluid (CSF) leakage. Occasionally, delayed facial nerve damage is seen.
Common otology viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Temporal bone fractures can be associated with conductive hearing loss or mixed sensorineural hearing loss. Otic capsule disrupting fractures cause severe to profound sensorineural hearing loss that is often immediately apparent. Otic capsule sparing fractures can manifest as both sensorineural hearing loss or conductive hearing loss. Conductive hearing loss are caused initially by haemotympanum or effusion, and permanent deficits are caused by disruption of ossicular chain. The most common ossicular chain injuries include subluxation of the incudostapedial joint, dislocation of incus and fracture of stapes crura. Middle ear exploration and ossicular chain reconstruction are considered when a conductive hearing loss persists for more than 2 months post injury. Alternatives to tympanoplasty and ossiculoplasty surgery include air conduction aids, bone conduction devices or CROS aids (in single-sided deafness).
Skull base osteomyelitis
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
CT will show bony erosion and thickening of the skin of the external ear canal (Figure 13.2). Often the ear canal and temporomandibular joint are involved initially, but all parts of the temporal bone may be affected. These changes would not be found in simple otitis externa. Erosion may extend inferiorly to involve the stylomastoid foramen or medially into the middle ear.
Simultaneous repair of bilateral temporal bone meningoencephaloceles by combined mastoid-middle cranial fossa approach
Published in Acta Oto-Laryngologica Case Reports, 2023
Kazuto Osaka, Takayuki Okano, Masahiro Tanji, Koichi Omori
Meningoencephalocele (MEC) is a rare clinical entity caused by herniation of the dura mater and brain tissue through bony defects in the skull base. MECs can be congenital, idiopathic (spontaneous), or acquired secondary to chronic inflammation, including that caused by otitis media or sinusitis, surgery, or head trauma [1]. Spontaneous MECs in the temporal bone may present with hearing loss, headache, otorrhea, and recurrent acute otitis media; in rare cases, they can present with otogenic meningitis or even a cerebral abscess [2]. To the best of our knowledge, no reports have described bilateral simultaneous surgery for bilateral temporal MECs [3–6]. We herein report a case of bilateral spontaneous MECs in the middle cranial fossa identified by recurrent bacterial meningitis and treated by simultaneous bilateral resection of the MECs and skull base reconstruction. We took advantage of the combined mastoid-middle cranial fossa approach because of the presence of multiple dehiscences in the bilateral middle cranial fossae [7]. After simultaneous bilateral resection of the MECs, we repaired the defects in the dura mater and bony wall of the middle cranial fossa using temporal fascia flaps and free bone grafts.
MATE1 expression in the cochlea and its potential involvement in cisplatin cellular uptake and ototoxicity
Published in Acta Oto-Laryngologica, 2023
Sofia Waissbluth, Agustín D. Martínez, Cindel Figueroa-Cares, Helmuth A. Sánchez, Juan C. Maass
P5 to P7 animals were sacrificed by decapitation (n = 20 cochleae). Both cochleae were obtained by skull dissection and brain removal. Both inner ears located in the temporal bone were isolated, and cochleae were delicately extracted. The dissection was performed using a modified bath solution made with (in mM) 138 NaCl, 5 KCl, 6 Glucose and 10 HEPES, pH7.4. and previously filtered and stored at 4 °C. Briefly, the bony tissue is separated from the membranous labyrinth. Next, the tissue is fixed in the basal region and the membrane labyrinth is extended radially out and split from the central modiolus. Then, the sensory epithelium is separated from the stria vascularis and spiral ligament, and finally transferred to a coverslip previously treated with Geltrex (Gibco A1569601, Life Technologies). In some experiments, the stria vascularis was maintained. Once that tissue is attached to the substrate, the coverslip is covered with culture medium (Dulbecco’s Modified Eagle Medium, containing ampicillin (10 μg/ml) and supplemented with 5% FBS and 5% horse serum) and incubated for 24 h at 37 °C with 5% CO2 and 95% humidity. During imaging experiments, cultures were exposed to the same modified bath solution used during dissection.
Development of a navigable 3D virtual model of temporal bone anatomy
Published in Journal of Visual Communication in Medicine, 2023
One of the most difficult and key anatomical areas to understand in human anatomy is the temporal bone. Both undergraduate and postgraduate students are expected to know this anatomy very well to better comprehend the myriad of otological and skull base diseases. The temporal bone is a complex bone and anatomically unique in multiple ways. Traditionally, temporal bones obtained from human cadavers have served as effective teaching tools for mastering ear anatomy and surgical skills and continue to be an ideal approach to date. However, temporal bone laboratories have high maintenance costs and cadaveric specimens are difficult to procure (Naik et al. 2014). In the last few years, the search for artificial temporal models has led to the emergence of other modalities of training. Virtual reality and simulation are safer and feasible alternatives, hence are being slowly incorporated as teaching tools for developing familiarity with surgical anatomy. They do however, carry a significant technology cost and may not be a feasible solution.