Facial schwannoma without facial paralysis

1989 ◽  
Vol 103 (10) ◽  
pp. 973-975 ◽  
Author(s):  
J. F. Sharp ◽  
A. I. G. Kerr ◽  
Pauline Carder ◽  
R. J. Sellar
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Jugular Bulb ◽  
Facial Canal ◽  
Facial Paresis ◽  
Stylomastoid Foramen ◽  
Seventh Nerve ◽  
Aural Polyp ◽  
Nerve Paresis ◽  
Middle Ear Cleft

AbstractA 64-year-old man with right aural discharge presented complaining of progressive deafness. Other otological symptoms were absent and specifically there was no seventh nerve paresis. A right aural polyp was identified and biopsied. Histology showed the polyp to be a schwannoma.Subsequent temporal bone computed tomography showed expansion of the distal facial canal. At operation, the schwannoma filled the middle ear cleft and extended from the genu to the region of the stylomastoid foramen. The floor of the middle ear had been eroded, exposing the jugular bulb.Facial paresis is the usual presenting feature of a facial schwannoma, while deafness, ageusia and reduced lacrimation are variable, dependent upon the site of the lesion. The absence of facial palsy as a presenting feature is very rare and this case illustrates the need for histological examination of all abnormal aural material.

An intact bony tympanic facial canal does not protect from secondary facial paresis in adult acute otitis media

2020 ◽  
Vol 134 (5) ◽  
pp. 409-414
Author(s):  
C Meerwein ◽  
S Pazahr ◽  
T M Stadler ◽  
N Nierobisch ◽  
A Dalbert ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Case Control Study ◽  
Acute Otitis Media ◽  
Case Control ◽  
Facial Canal ◽  
Facial Paresis ◽  
Retrospective Case ◽  
Control Study

AbstractObjectiveTo investigate the prevalence of bony dehiscence in the tympanic facial canal in patients with acute otitis media with facial paresis compared to those without facial paresis.MethodA retrospective case–control study was conducted on acute otitis media patients with facial paresis undergoing high-resolution temporal bone computed tomography.ResultsForty-eight patients were included (24 per group). Definitive determination of the presence of a bony dehiscence was possible in 44 out of 48 patients (91.7 per cent). Prevalence of bony dehiscence in acute otitis media patients with facial paresis was not different from that in acute otitis media patients without facial paresis (p = 0.21). Presence of a bony dehiscence was associated with a positive predictive value of 66.7 per cent in regard to development of facial paresis. However, an intact bony tympanic facial canal did not prevent facial paresis in 44.8 per cent of cases (95 per cent confidence interval = 34.6–55.6).ConclusionPrevalence of bony dehiscence in acute otitis media patients with facial paresis did not differ from that in acute otitis media patients without facial paresis. An intact tympanic bony facial canal does not protect from facial paresis development.

The Petromastoid Canal

1983 ◽  
Vol 92 (6) ◽  
pp. 640-644 ◽  
Author(s):  
Bruce Proctor
Keyword(s):  
Blood Vessels ◽  
Posterior Fossa ◽  
Middle Ear ◽  
Cell System ◽  
Facial Canal ◽  
Bony Labyrinth ◽  
Middle Ear Cleft ◽  
Petromastoid Canal

The embryology and anatomy of the petromastoid canal is reviewed. This structure may be responsible for the passage of some infections of the middle ear cleft into the posterior fossa. It also transmits important blood vessels to a portion of the bony labyrinth, to the facial canal, and to the mucosa of the mastoid air cell system.

scholarly journals Clinicoradiological correlation between preoperative high-resolution computed tomography findings and intraoperative findings in chronic otitis media (squamous type)

2021 ◽  
Vol 7 (5) ◽  
pp. 797
Author(s):  
Girish Mishra ◽  
Yojana Sharma ◽  
Sona Patel ◽  
Viral Patel
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Jugular Bulb ◽  
Facial Canal ◽  
High Resolution Computed Tomography ◽  
K Value ◽  
Tegmen Tympani ◽  
Good Agreement

<p class="abstract"><strong>Background:</strong> Chronic otitis media is a major health problem with significant morbidity. High-resolution computed tomography (HRCT) is extremely useful for middle ear pathology and extension of the disease. The objective was to study the correlation between preoperative HRCT and intraoperative findings in chronic suppurative otitis media (squamous type).</p><p class="abstract"><strong>Methods:</strong> This analytical study included 61 cases of chronic otitis media (squamous type). Preoperative HRCT findings were correlated with intraoperative findings. Sensitivity, specificity, PPV, NPV and kappa value were estimated.</p><p class="abstract"><strong>Results:</strong> Out of 61 cases 32 were males and 29 were females. Presence of cholesteatoma found on HRCT with 80% sensitivity with k value 0.83 suggesting very good agreement. About ossicular status k value of incus, malleus and stapes were 0.76, 0.65 and 0.54 respectively with sensitivity of 91%, 85% and 58% respectively. Other critical areas on HRCT like sigmoid sinus plate erosion, tegmen tympani dehiscence, scutum erosion, lateral semicircular canal erosion, facial canal erosion and jugular bulb were seen with k value was about 1, 0.8, 0.9, 0.82, 0.72 and 0.65 respectively. So, HRCT shows perfect radiosurgical agreement for sinus plate erosion, very good agreement for disease extension, incus erosion, tegmen tympani erosion, scutum erosion and LSCC erosion and fair agreement for malleus erosion, facial canal erosion and jugular bulb dehiscence and poor agreement for stapes erosion.</p><p class="abstract"><strong>Conclusions:</strong> HRCT is a reliable preoperative investigation in cases of chronic otitis media, squamosal type which would provide  a bird’s eye view in the disease process in the ear.</p>

scholarly journals Usefulness of High Resolution Computed Tomography scans in depicting the status of the middle ear structures

2019 ◽  
Vol 6 (2) ◽  
pp. 449
Author(s):  
Ponnam Bharath Kumar ◽  
Kiran Mai ◽  
Santosh Karpur
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Middle Ear ◽  
High Resolution Computed Tomography ◽  
Bony Labyrinth ◽  
The Status ◽  
Hrct Temporal Bone ◽  
Operative Assessment ◽  
Middle Ear Cleft

Background: Prior to surgery it is very important that the surgeon is fully aware, and he should have the clear picture as to the extent of the disease and the nature of the disease to give satisfactory surgical outcomes for the patient. HRCT (High resolution computed tomography) is one such guiding tool for the surgeon. The objective was to study usefulness of HRCT scan in attico-antral disease in depicting the status of the middle ear structures.Methods: A total of 30 patients were studied.  HRCT temporal bone was performed by using SIEMENS EMOTION 16 slice CT machine in axial plane and coronal images were reformatted. Findings of HRCT temporal bone were recorded.  Findings of mastoid exploration surgery were recorded. Report of HRCT of temporal bone was correlated with surgical findings and tabulated using percentages.Results: Surgery showed cholesteatoma in 26 (86.6%) patients. Epitympanum was involved in 29 (96.6%) patients in HRCT and 30 (100%) patients at surgery. Extension beyond middle ear cleft was seen in 4 (13.3%) patients in HRCT and 5 (16.6%) patients at surgery. Tympanic segment of facial canal was the most commonly involved, showing erosion in 10 (33.3%) patients in HRCT and 12 (40%) patients at surgery. Lateral SCC was the most commonly involved in bony labyrinth seen in 4 (13.3%) patients in both HRCT and surgery. Erosion of dural plate was seen in 6 (20%) patients in HRCT whereas 9 (30%) patients showed dural plate erosion at surgery.Conclusions: HRCT of temporal bone plays a promising role in pre-operative assessment of cholesteatoma as it depicts the extent of the disease and integrity of most of the middle ear structures.

Polipous chronic middle ear otitis – case report

ORL ro ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 20-22
Author(s):  
A. Sandul ◽  
M. Buracovschi ◽  
N. Buracovschi ◽  
I. Gusacinschi
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Otitis Media ◽  
Middle Ear ◽  
Type Ii ◽  
Ear Ossicles ◽  
Aural Polyp

The authors present a case of chronic polyposis otitis media in a 32-year-old patient treated in Clinical Republican Hospital. Computed tomography revealed the presence of an aural polyp which originated from middle ear ossicles. The aural polyp was surgically removed through microdebridation and a type II Wullstein tympanoplasty was performed.   

Temporal Bone Anomalies Associated with Congenital Heart Disease

1979 ◽  
Vol 88 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Tetsuya Egami ◽  
Isamu Sando ◽  
Eugene N. Myers
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Middle Ear ◽  
Congenital Heart ◽  
Jugular Bulb ◽  
Facial Canal ◽  
Large Defect ◽  
High Jugular Bulb ◽  
Ear Anomalies ◽  
Bone Anomalies

A temporal bone histopathological study was conducted to detect temporal bone anomalies in 20 ears (10 cases) of individuals with congenital heart anomalies. We restricted our study to patients more than one year of age, and to heart anomalies of unknown etiology. The temporal bones were obtained from refrigerated cadavers, fixed in formalin, embedded in celloidin, cut in a horizontal plane, stained with H & E, and mounted on glass slides for light microscopic study. Anomalies observed in the middle ear were: remnants of mesenchymal tissue (8 ears), wide angle of the facial genu (6 ears), persistence of the stapedial artery (5 ears), large defect of the facial canal (4 ears), high jugular bulb (4 ears), and bulky incus (2 ears). Inner ear anomalies consisted of a shortened cochlea (5 ears), anomaly of the horizontal canal (3 ears), anomaly of the posterior canal (2 ears), obliteration of the cochlear aqueduct (2 ears), and patent utriculoendolymphatic valve (1 ear). Most of the anomalies observed appeared to be due to arrested development, and resembled features which may be found at various stages of fetal life. Structural anomalies were more commonly found in the mesoderm than in the ectoderm, and middle ear anomalies were more frequently encountered than anomalies of the inner ear. No definite relationship between these anomalies observed in the temporal bone and hearing problems which had been recorded clinically for these patients could be detected. However, the large defect (more than one third of the circumference) of the facial canal, the high jugular bulb, and the stapedial artery persistence should be recognized as problems since they may be encountered during middle ear surgery.

scholarly journals Bilateral Inflammatory Aural Polyps: A Manifestation of Samter's Triad

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Robert Brobst ◽  
Nichole Suss ◽  
Stephanie Joe ◽  
Miriam Saadia-Redleaf
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Unusual Case ◽  
History Of ◽  
Samter’S Triad ◽  
The Right ◽  
Inflammatory Changes ◽  
Air Cells ◽  
Middle Ear Cleft ◽  
Mastoid Air Cells

We report an unusual case of bilateral inflammatory aural polyps in a patient with Samter's triad. This 52-year-old patient had a history of chronic rhinosinusitis with sinonasal polyps, asthma, and aspirin sensitivity, with progressive right-sided hearing loss, otorrhea, and aural fullness. She was found to have bilateral aural polyps, with the larger obstructing lesion on the right. A computed tomography supported these findings and revealed bilateral opacification of the middle ear cleft and mastoid air cells. An initial right tympanomastoidectomy was performed with the specimen histologically resembling a typical sinonasal polyp. We speculate that this patient's middle ear polyposis is secondary to the inflammatory changes of Samter's triad. This has not been described previously in the literature.

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

scholarly journals Isolated Congenital Mastoid Cholesteatoma with no Involvement of Aditus Ad Antrum and Middle Ear

2021 ◽  
Vol 14 ◽  
pp. 117954762110140
Author(s):  
Pace Annalisa ◽  
Iannella Giannicola ◽  
Rossetti Valeria ◽  
Messineo Daniela ◽  
Visconti Irene Claudia ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Middle Ear ◽  
Mastoid Process ◽  
Reference List ◽  
Digastric Muscle ◽  
Diagnostic Features ◽  
Imaging Evaluation ◽  
Stylomastoid Foramen ◽  
Congenital Origin ◽  
Mastoid Region

Cholesteatoma is a non-neoplastic, keratinized squamous epithelial lesion that affects the temporal bone. The middle ear is the most frequent, while the isolated cholesteatoma of the mastoid is rare. The aim of this study was to describe a rare case of isolated mastoid cholesteatoma with no involvement of aditus ad antrum and middle ear including a literature review of the topic. This case report describes the case of a 58 years old female with a cholesteatoma isolated in the mastoid region, evidenced by imaging (computer tomography and magnetic resonance). A mastoidectomy was performed: mastoid process was completely involved, but antrum was not reached. Moreover, it reached the soft tissue of stylomastoid foramen as well as the posterior belly of the digastric muscle. In the literature few articles described cases of cholesteatoma isolated in the mastoid region. Research was conducted using PubMed and reference list and there were considered only reports about cholesteatoma exclusively located in the mastoid process without involvement of antrum or middle ear. Fourteen articles were included in this review, with a total number of 23 cases of cholesteatoma isolated in the mastoid region. All papers analyzed reported the cases of isolated mastoid cholesteatoma that presented a congenital origin. Its diagnosis is difficult, therefore, imaging evaluation is mandatory and surgery is the treatment of choice. Mastoid cholesteatomas without involvement of aditus ad antrum and middle ear are rare and only 23 cases are reported in literature. Our case is in line with all clinical and diagnostic features of this rare disease, but it is the only one that evidenced an exposure of the soft tissue of stylomastoid foramen as well as the posterior belly of the digastric muscle. The treatment of choice was the surgical one, avoiding damaging of important anatomo-functional structure.

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