Aneurysmal bone cyst of the temporal bone: case report

BACKGROUND: Aneurysmal bone cysts (ABCs) are uncommon lesions of the temporal bone and their occurrence in the calvarium is rare. CASE DESCRIPTION: A case of a right temporal ABC is reported in a 14-year-old boy who presented swelling of the right temporal region. Magnetic resonance imaging showed a destructive and expansile bone lesion on the right anterior temporal and orbital bone. The lesion was removed in total by the right temporal craniotomy and orbitozygomatic osteotomy. ABC was diagnosed in the pathologic examination. The patient had good recovery during the postoperative course. CONCLUSIONS: This report presents the diagnosis and imaging of an ABC in the temporal bone. This localization is very rare for ABC. Total excision, if feasible, is the ideal treatment.     

Human Temporal Bone Removal: The Skull Base Block Method

Objectives To describe a technique for harvesting larger temporal bone specimens from human cadavers for the training of otolaryngology residents and fellows on the various approaches to the lateral and posterolateral skull base. Design Human cadaveric anatomical study. The calvarium was excised 6 cm above the superior aspect of the ear canal. The brain and cerebellum were carefully removed, and the cranial nerves were cut sharply. Two bony cuts were performed, one in the midsagittal plane and the other in the coronal plane at the level of the optic foramen. Setting Medical school anatomy laboratory. Participants Human cadavers. Main Outcome Measures Anatomical contents of specimens and technical effort required. Results Larger temporal bone specimens containing portions of the parietal, occipital, and sphenoidal bones were consistently obtained using this technique of two bone cuts. All specimens were inspected and contained pertinent surface and skull base landmarks. Conclusions The skull base block method allows for larger temporal bone specimens using a two bone cut technique that is efficient and reproducible. These specimens have the necessary anatomical bony landmarks for studying the complexity, utility, and limitations of lateral and posterolateral approaches to the skull base, important for the education of otolaryngology residents and fellows.     

TEMPORAL BONE MENINGIOMAS

Meningiomas should be considered in the differential diagnosis of space-occupying lesions of the temporal bone. Five cases of meningiomas of the temporal bone are described and the literature reviewed. These tumours may stimulate Schwannornas and glomus tumours in their presentation and radiological findings. The tumours were managed by combining standard neurosurgical approaches with temporal bone and skull base techniques.     

Inflammatory Pseudotumor of the Temporal Bone: A Case Series

Inflammatory pseudotumor is a non-neoplastic inflammatory process. Histologically these lesions appear as an inflammatory infiltrate with a fibrotic background. Clinical presentations vary from slow growth with minimal mass effect, to bony destruction that can mimic malignancy. Although they occur most commonly in the orbit, there are a growing number of case reports of tumors of the temporal bone and skull base. Inflammatory pseudotumors of the temporal bone are best treated by excision, with radiation and steroid therapy reserved for inoperable tumors. The clinical, histologic, and radiographic features of two patients with inflammatory pseudotumor of the temporal bone are presented.     

Lateral Temporal Bone Resection in Advanced Cutaneous Squamous Cell Carcinoma: Report of 35 Patients

Objective To evaluate lateral temporal bone resection (LTBR) in the management of advanced cutaneous squamous cell carcinoma (SCC) with temporal bone invasion and patterns of failure.Methods This is a retrospective study of 35 patients undergoing lateral temporal bone resection for advanced cutaneous SCC at a tertiary care center between 1995 and 2006.Results The Pittsburgh tumor stage was T4 in 18 patients (51%), T3 in 5 (14%), T2 in 9 (26%), and T1 in 3 (9%). Clear margins were reported in 22 (63%) patients. Resection of the mandible and/or temporomandibular joint (TMJ) was required in 11 (31%) patients. Facial nerve involvement was seen in 10 (29%) patients. Survival outcomes at 2 and 5 years for overall survival were 72% and 49%; disease-free survival, 68% and 59%; and disease-specific survival, 79% and 62%, respectively. Pittsburgh T stage correlated significantly with disease-specific survival (p = 0.015) and margin status was significant for both disease-free survival (p = 0.0015) and disease-specific survival (p < 0.001).Conclusions Surgery with curative intent is justified for cutaneous SCC invading the temporal bone with extended LTBR. Margin status was a significant predictor of outcome. Surgeons should plan preoperatively to achieve clear margins by extending the LTBR with possible nerve resection.     

Primary intraosseous meningioma of the temporal bone in an infant. A case report

Primary intraosseous meningioma of the skull bone is a very rare entity. Although in can occur at any age, it is very rare in children. We present a case and review the literature.     

标准外伤大骨瓣开颅治疗重型额颞部颅脑损伤

目的:探讨标准外伤大骨瓣开颅在重型额颞部颅脑损伤中的应用价值。方法:采用美国标准外伤大骨瓣开颅术治疗重型额颞部颅脑损伤48例，术后均入神经外科重症监护病房，注意保持气道通畅，并给予脱水、促醒等对症支持治疗。结果:存活32例(66．7％)，其中良好21例，中残6例，重残3例，植物生存2例，死亡16例。结论:标准外伤大骨瓣开颅术是治疗重型额颞部颅脑损伤的良好术式。     

Malignancies of the external auditory canal and temporal bone: a review

Background : Malignancies of the external auditory canal and temporal bone are uncommon. A retrospective review was conducted of a large series treated at the Prince of Wales hospital between 1974 and 1995. Methods : Retrospective review of 59 cases of ear canal and temporal bone malignancies. These were analysed according to histopathology, disease extent, surgery, margin status and survival. A TNM‐type staging system was applied to 51 cases and Kaplan–Meier survival analysis applied to this group. Results : The 5‐year cancer‐specific survival (CSS) for the series was 54%. For stages 1, 2, 3 and 4 disease, the CSS were 90, 45, 40 and 19%, respectively. Survival was significantly higher where clear surgical margins were achieved (80 vs 35%). Conclusions : Carcinoma of the external ear canal is rare and, in Australia, is often related to recurrence of periauricular cutaneous malignancy. Surgical extirpation with clear margins provides the best survival.     

VERRUCOUS CARCINOMA OF THE TEMPORAL BONE

A case report of a patient suffering from severe otalgia for 12 months and intermittent otonhoea over a 53 year period is presented. Diagnosed as verrucous carcinoma of the temporal bone, this is only the ninth case found in the literature. The difficulty of histological diagnosis and subsequent management are important features.     

Endolymphatic sac tumor: unique features of two cases and review of the literature

Summary.  Endolymphatic sac tumors (EST) are rare intracranial tumors originating from the pars rugosa of the endolymphatic sac. Although typically described as histologically nonaggressive lesions, nevertheless they are termed adenocarcinomas and often become locally invasive. We report two patients with histologically proven EST with unique clinical features: the first pediatric case of an EST in an 11-year-old patient whose complaints started at the age of seven; and, a second patient, a 43-year-old man, the first report of metastatic EST which appeared in a remote location from the original site of surgery. Both patients underwent gamma-knife radiosurgery for recurrent tumor. This treatment has not been described previously for these tumors. Both patients have a follow-up of 7 years. Although not disease free they remain neurologically stable. We review the literature on EST. Published online October 10, 2002 Correspondence: Mark C. Preul, M.D., c/o Neuroscience Publications; Barrow Neurological Institute, 350 West Thomas Road; Phoenix, AZ 85013-4496.     

带颞浅动脉蒂颅骨外板移植修复面部凹陷畸形

自1991年4月起我们应用带颞浅动脉蒂颅骨外板移植修复面部凹陷畸形7例获满意效果,此皮瓣具有接近受区骨质并近似面骨、术后骨质吸收少、供区隐蔽、术后疼痛轻等优点。     

Incidence of osteoradionecrosis of the temporal bone

Background: Osteoradionecrosis of the temporal bone is a serious, late complication of radiotherapy to the temporal bone region. The aim of this study was to determine the incidence, risk and protective factors relating to the development of osteoradionecrosis of the temporal bone. Methods: This is a retrospective review of prospectively collected data. A single surgeon collated a database over a 10‐year period regarding patients undergoing surgery and subsequent radiotherapy for head and neck malignancies. This was reviewed, and information pertaining to demographics, nature of disease, radiation treatment regime and complications including osteoradionecrosis was extracted. Statistical analysis was then completed independently. Results: A total of seven patients from the cohort of 82 developed osteoradionecrosis of the temporal bone within the period of the data collection. This represents an incidence of 8.5% (95% confidence interval = 3.6–13.4%). All who developed osteoradionecrosis had a metastatic parotid squamous cell carcinoma treated operatively with subsequent radiotherapy. There were no statistically significant risks or prognostic factors identified. Mean duration of follow‐up was 32 months. Conclusion: The incidence of osteoradionecrosis of the temporal bone was 8.5% (95% confidence interval = 3.6–13.4%). Osteoradionecrosis of the temporal bone can present in excess of 10 years after treatment completion. This result may actually under ‐represent the true incidence of the complication. It has significant morbidity associated with its development and, occasionally, mortality. Those people undergoing radiotherapy to the parotid region may be at higher risk of osteoradionecrosis. A new classification system for osteoradionecrosis of the temporal bone has been proposed.     

Sensory and motor trigeminal evoked potentials to localize the position of trigeminal electrodes

Summary The results of 16 cases of temporal bone resection were evaluated. The resections, 12 of which were total and 4 partial, had mostly been performed for squamous cell carcinoma invading the temporal bone. Five patients in whom the intervention was considered radical and not followed by irradiation, were alive and well 9 years or more later. The significance of postoperative radiotherapy was demonstrated in 3 patients who were alive and in good health 9 years or more later, although histological examination of resection margins showed residual tumour. Eight patients died 10 months to 5 1/3 years after operation, 6 of whom from recurrence, one from radiation necrosis of the temporal lobe of the brain, and one from cerebrovascular occlusion. Histologically, squamous cell carcinoma was found significantly more among the patients who died from recurrence than among those still living.     

带颞浅动脉蒂颅骨外板移植修复面部凹陷畸形

自１９９１年４月起我们应用带颞浅动脉蒂颅骨外板移植修复面部凹陷畸形７例获满意效果，此皮瓣具有接近受区骨质并近似面骨、术后骨质吸收少、供区隐蔽、术后疼痛轻等优点     

Malignant tumors of the ear and temporal bone: a study of 27 patients and review of their management.

Objective: To evaluate the management of patients with malignant tumors of the ear and temporal bone. Design: Retrospective analysis of data. Setting: Radcliffe Infirmary, Oxford, United Kingdom. Participants: Twenty-seven patients were classified into two groups according to the site of origin of the tumor: (1) superficial (17 tumors): tumors arising from the skin of the pinna, parotid, and temporomandibular joint area; (2) deep (10 tumors): tumors arising in the ear canal and temporal bone. Main Outcome Measures: Treatment modality, complications, recurrence rate, disease-free interval, and survival. Results: The mean follow-up period was 25 months (0 to 60), and the median overall survival 46 months (0 to 102). Complications occurred in 6 patients (22%). The 3-year survival was 38% (95% confidence interval [CI], 19 to 58%), and the 5-year survival 19% (95% CI, 3 to 35%). Conclusions: There were insufficient data to demonstrate any difference in survival or disease-free interval related to the site of tumor origin (superficial versus deep tumors). There were independent differences in survival in favor of both performing parotidectomy and using postoperative radiotherapy, but neither reached significance at the 0.05 level.     

Primary Ewing sarcoma of the petrous temporal bone: an exceptional cause of facial palsy and deafness in a nursling

BACKGROUND: Primary Ewing sarcoma affecting the skull base in general and the petrous bone in particular is extremely rare with only 4 reports of Ewing sarcoma arising in the petrous temporal bone in the international medical literature. METHODS: The authors report for the first time a case of a primary Ewing sarcoma of the petrous temporal bone in a 5-month-old nursling, which became apparent with a complete peripheral facial palsy and ipsilateral surdity. RESULTS: The neoformation was treated by systemic chemotherapy and radiation of the tumor region. The diagnostic steps, therapy, and development of the child are described in detail; the literature concerning Ewing sarcoma originating from the skull in general and from the petrous temporal bone in particular is reviewed. CONCLUSIONS: The highlights of this case are an extremely uncommon location, an unusual age of presentation, as well as a unique set of symptoms.     

Primary Ewing's sarcoma of the temporal bone with intracranial, extracranial and intraorbital extension. Case report

Primary cranial Ewing's sarcoma is a very rare malignant tumor. Primary temporal bone Ewing's sarcoma with intraorbital extension is also a very rare condition.In this article we describe a case of primary Ewing's sarcoma of the temporal bone which extended into intracranial, extracranial and intraorbital compartments; manifesting with a swelling in the zygomatic fossa and proptosis of the right eye. The tumor was excised partially, and the patient underwent radiochemotherapy. The patient died 6 months after the therapy, with lung metastasis.The case is discussed with the pertinent literature.