Unusual middle-ear mischief: trans-tympanic trauma from a hair grip resulting in ossicular, facial nerve and oval window disruption

2006 ◽  
Vol 120 (9) ◽  
pp. 793-795 ◽  
Author(s):  
J D Snelling ◽  
A Bennett ◽  
P Wilson ◽  
M Wickstead
Keyword(s):  
Facial Nerve ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Oval Window ◽  
Delayed Presentation ◽  
Stapes Footplate ◽  
Horizontal Portion

A case of piercing of the tympanic membrane, resulting in unusual consequences, is described. This is the first reported case of the long process of a dislocated incus resulting in trauma to the horizontal portion of a dehiscent facial nerve. Simultaneous depression of the stapes footplate resulted in a perilymph leak, but with delayed presentation.

The ear

2021 ◽  
pp. 497-518
Author(s):  
Daniel R. van Gijn ◽  
Jonathan Dunne
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Middle Ear ◽  
Semicircular Canals ◽  
Lateral Wall ◽  
Oval Window ◽  
External Ear ◽  
Membranous Labyrinth ◽  
Stapes Footplate ◽  
Petrous Temporal Bone

The delicate yet definitive deflections of the pinna (wing/fin) of the external ear contribute to the collection of sound. The external acoustic meatus is responsible for the transmission of sounds to the tympanic membrane, which in turn separates the external ear from the middle ear. The middle ear is an air filled (from the nasopharynx via the eustachian tube), mucous membrane lined space in the petrous temporal bone. It is separated from the inner ear by the medial wall of the tympanic cavity – bridged by the trio of ossicles. The inner ear refers to the bony and membranous labyrinth and their respective contents. The osseus labyrinth lies within the petrous temporal bone. It consists of the cochlea anteriorly, semicircular canals posterosuperiorly and intervening vestibule – the entrance hall to the inner ear whose lateral wall bears the oval window occupied by the stapes footplate.

On the hearing effects of a cholesteatoma growing: A biomechanical study

2021 ◽  
pp. 095441192110466
Author(s):  
Leonor Mendonça ◽  
Carla F Santos ◽  
Fernanda Gentil ◽  
Marco Parente ◽  
Bruno Areias ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Sound Pressure ◽  
Chronic Otitis Media ◽  
Biomechanical Study ◽  
The Finite Element Method ◽  
High Frequencies ◽  
Initial Stage ◽  
Hearing Function ◽  
Stapes Footplate

Chronic otitis media enables the appearance of a benign middle ear tumor, known as a cholesteatoma, that may compromise hearing. To evaluate the influence of a cholesteatoma growth on the hearing function, a computational middle ear model based on the finite element method was used and three different size of cholesteatoma were modeled. The cholesteatoma solidification and the consequent degradation of the ossicles were also simulated as two condition that commonly occurs during cholesteatoma evolution. A sound pressure level of 80 dB SPL was applied in the tympanic membrane and a steady state analysis was performed for frequencies from 100 Hz to 10 kHz. The displacements of both the tympanic membrane and the stapes footplate were measured. The results were compared with a healthy case and it was shown that the cholesteatoma development leads to a decrease in the umbo and stapes displacements. The ossicles degradation simulation showed the higher difference comparing with the cholesteatoma in an initial stage, with lower displacements in the stapes footplate mainly for high frequencies. The observed displacement differences are directly connected to hearing loss, being possible to conclude that cholesteatoma evolution in the middle ear will lead to hearing problems, mainly in an advanced stage.

Facial nerve palsy secondary to middle-ear lipoma

2008 ◽  
Vol 122 (6) ◽  
Author(s):  
A V Kasbekar ◽  
N Donnelly ◽  
P Axon
Keyword(s):  
Facial Nerve ◽  
Middle Ear ◽  
Facial Palsy ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Fatty Tissue ◽  
Early Imaging ◽  
Horizontal Portion ◽  
Tomography Scan ◽  
Middle Ear Cleft

AbstractObjective:We present the first reported case of a middle-ear lipoma presenting with facial nerve palsy. We review the available literature on middle-ear lipomas and alert the surgeon to the possibility of a lipoma occurring in this location.Case report:A 33-year-old man presented to our unit with a right-sided, House–Brackmann grade two, lower motor neurone facial palsy. A computed tomography scan revealed abnormal soft tissue in the epitympanic recess, extending to the region of the geniculate ganglion. At middle-ear exploration, a lump of fatty tissue was found filling the anterior middle-ear cleft, juxtaposed to the horizontal portion of the facial nerve. The patient's facial palsy resolved within a few weeks of surgery.Conclusion:Lipomas are a rare but real differential diagnosis of a mass in the middle ear. Early imaging is advised.

A case of middle-ear cavernous lymphangioma with facial palsy

2010 ◽  
Vol 125 (4) ◽  
pp. 405-409 ◽  
Author(s):  
R Hirai ◽  
M Ikeda ◽  
H Kishi ◽  
Y Nomura ◽  
S Shigihara
Keyword(s):  
Facial Nerve ◽  
Middle Ear ◽  
Facial Palsy ◽  
Histopathological Examination ◽  
Single Case ◽  
Nerve Tissue ◽  
Tumour Invasion ◽  
Benign Tumours ◽  
Horizontal Portion

AbstractObjective:Only a few benign tumours of the middle ear have been reported to lead to the development of facial palsy. Here, we describe a patient with middle-ear cavernous lymphangioma and facial palsy.Study design:Single case study.Patient:A 61-year-old man presented with left-sided hearing impairment and incomplete left facial palsy. A tumour was confirmed to be occupying the epi- to mesotympanum and to be joined to the facial nerve. The tumour was removed along with facial nerve tissue, which was resected at its horizontal portion, and the remaining facial nerve was fixed by end-to-end anastomosis. Complete facial paralysis occurred after the operation, but the patient's House–Brackmann grade gradually improved to grade III. Post-operative histopathological examination revealed infiltration of the lymphangioma into the facial nerve tissue, together with mild neural atrophy of the facial nerve.Conclusion:These findings suggested that tumour invasion was the cause of facial palsy in this patient.

scholarly journals Vibrometric studies of the middle ear of the bullfrogRana catesbeianaII. The operculum

2002 ◽  
Vol 205 (20) ◽  
pp. 3167-3176 ◽  
Author(s):  
Matthew J. Mason ◽  
Peter M. Narins
Keyword(s):  
Middle Ear ◽  
Free Field ◽  
Laser Interferometry ◽  
Shoulder Girdle ◽  
Seismic Signal ◽  
High Amplitude ◽  
Oval Window ◽  
Stapes Footplate ◽  
New Evidence ◽  
Additional Role

SUMMARYThe operculum and stapes footplate, the two moveable elements within the oval window of the frog, have been thought to function independently. In this study, laser interferometry was used to record the vibrations of both structures in response to free-field airborne sound. Contrary to expectation,the operculum appears to be coupled to the footplate. Coupling is achieved both by means of ligaments and by a cartilaginous flange of the footplate that underlies the operculum. The stapes footplate rotates about an axis located ventrolaterally, but the axis for the operculum is dorsomedial. As a result of this unusual morphology, the opercularis muscle, which connects the operculum and shoulder girdle, can potentially affect the movements of both the operculum and footplate. The proposed roles of the opercularis system in seismic signal detection and extratympanic sound transmission are critically reviewed in the light of this new evidence. An alternative or additional role for the opercularis system is proposed, involving the protection of the inner ear from high-amplitude displacements of the stapes footplate during breathing and vocalisation.

scholarly journals Evaluation of the Facial Recess and Cochlea on the Temporal Bone of Stillbirths regarding the Percutaneous Cochlear Implant

2017 ◽  
Vol 22 (03) ◽  
pp. 260-265
Author(s):  
Gabriela Braga ◽  
Eloisa Gebrim ◽  
Ramya Balachandran ◽  
Jack Noble ◽  
Robert Labadie ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Facial Nerve ◽  
Cochlear Implant ◽  
Tympanic Membrane ◽  
Temporal Bone ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Facial Recess ◽  
Ct Evaluation ◽  
Temporal Bone Anatomy

Introduction The literature shows that there are anatomical changes on the temporal bone anatomy during the first four years of life in children. Therefore, we decided to evaluate the temporal bone anatomy regarding the cochlear implant surgery in stillbirths between 32 and 40 weeks of gestational age using computed tomography to simulate the trajectory of the drill to the scala timpani avoiding vital structures. Objectives To measure the distances of the simulated trajectory to the facial recess, cochlea, ossicular chain and tympanic membrane, while performing the minimally invasive cochlear implant technique, using the Improvise imaging software (Vanderbilt University, Nashville, TN, US). Methods An experimental study with 9 stillbirth specimens, with gestational ages ranging between 32 and 40 weeks, undergoing tomographic evaluation with individualization and reconstruction of the labyrinth, facial nerve, ossicular chain, tympanic membrane and cochlea followed by drill path definition to the scala tympani. Improvise was used for the computed tomography (CT) evaluation and for the reconstruction of the structures and trajectory of the drill. Results Range of the distance of the trajectory to the facial nerve: 0.58 to 1.71 mm. to the ossicular chain: 0.38 to 1.49 mm; to the tympanic membrane: 0.85 to 1.96 mm; total range of the distance of the trajectory: 5.92 to 12.65 mm. Conclusion The measurements of the relationship between the drill and the anatomical structures of the middle ear and the simulation of the trajectory showed that the middle ear cavity at 32 weeks was big enough for surgical procedures such as cochlear implants. Although cochlear implantation at birth is not an indication yet, this study shows that the technique may be an option in the future.

scholarly journals Pintail Comb Injury as a Rare Cause of Penetrating Temporal Bone Trauma With Facial Paralysis

2020 ◽  
pp. 014556132096893
Author(s):  
Dylan Jacob Cooper ◽  
Stanley Pelosi
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Facial Nerve ◽  
Tympanic Membrane ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Middle Ear ◽  
Complete Resolution ◽  
Bone Trauma ◽  
Nerve Dysfunction

We present a case of novel penetrating temporal bone trauma with a pintail comb causing facial paralysis. We describe a 42-year-old woman with acute facial paralysis, hearing loss, and dizziness following accidental tympanic membrane puncture. The patient underwent middle ear exploration with tympanoplasty and was found to have an intact but severely edematous facial nerve. The patient demonstrated less than 90% degeneration under electroneuronography and was treated medically without decompression, and by 6 months had exhibited complete resolution of facial nerve dysfunction with normal hearing. This case report highlights a unique cause of penetrating temporal bone trauma and supports the utility of electroneuronography in predicting the likelihood of recovery and need for decompression in patients where the facial nerve has obvious signs of trauma but remains grossly intact.

How does Prosthesis Head Size Affect Vibration Transmission in Ossiculoplasty?

2007 ◽  
Vol 137 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Manohar Bance ◽  
Alfredo Campos ◽  
Lillian Wong ◽  
David P. Morris ◽  
Rene van Wijhe
Keyword(s):  
Tympanic Membrane ◽  
Temporal Bone ◽  
Middle Ear ◽  
Laser Doppler Vibrometer ◽  
Head Size ◽  
Systematic Effect ◽  
Acoustic Frequency ◽  
Vibration Transmission ◽  
Stapes Footplate ◽  
Temporal Bones

OBJECTIVES: The transmission of vibrations from the tympanic membrane to the stapes footplate by an ossicular reconstruction prosthesis is affected by the size of the prosthesis head. We sought to determine if augmenting or reducing the head size of prosthesis had a systematic effect on transmission of vibrations to the stapes. STUDY DESIGN: We conducted a fresh cadaveric temporal bone middle ear study. METHODS: The incus was replaced with a prosthesis using a tympanic membrane to stapes head (TASH)-type hydroxyapatite prosthesis in nine fresh cadaveric temporal bones. Three prosthesis head sizes were created: unaltered, reduced, and augmented. Stapes vibrations were measured with a laser Doppler vibrometer in response to acoustic frequency chirps at 90 dB SPL. RESULTS: All three head size prostheses resulted in smaller stapes vibrations than the intact ear. There was no difference in the vibration transmission between the three different head sizes. All prostheses showed a vibration loss of 10 to 15 dB compared to the intact ear. CONCLUSIONS AND SIGNIFICANCE: Within the range of sizes tested, prosthesis head size had little impact on vibration transmission to the stapes footplate.

Key methods of identifying the horizontal facial nerve during difficult middle-ear surgery

2013 ◽  
Vol 127 (3) ◽  
pp. 303-305
Author(s):  
M I Syed ◽  
M Madurska ◽  
B F O'Reilly
Keyword(s):  
Facial Nerve ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Oval Window ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Early Stages

AbstractBackground:The key to avoiding damage to the horizontal facial nerve in middle-ear surgery is to formally identify the nerve in the early stages of the procedure.Methods:In the non-infected ear this can be achieved relatively easily by identifying the oval window niche. However, in the infected ear with cholesteatoma, the safest landmark to use is the processus cochleariformis, which can be identified by three different methods.Conclusion:In an infected ear that is full of granulation tissue and/or cholesteatoma, the horizontal facial nerve can be reliably identified by locating the processus cochleariformis using the three methods described. This avoids damage to the nerve and important structures around it.

Reporting and Description for Congenital Middle Ear Malformations to Facilitate Surgical Management

2018 ◽  
Vol 127 (10) ◽  
pp. 717-725 ◽  
Author(s):  
Feng Yang ◽  
Yang Liu
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
Round Window ◽  
Ossicular Chain ◽  
Oval Window ◽  
Surgical Approaches ◽  
Type I ◽  
Different Types ◽  
Ear Malformations ◽  
Stapes Footplate

Introduction: The aim of this work was to report and describe the different types of congenital middle ear malformations in order to guide surgical treatment approaches and improve outcomes for affected patients. Methods: The authors reviewed patients with congenital middle ear malformations who received surgical treatment between September 2010 and March 2017. Patient characteristics, middle ear deformities, and surgical procedures were documented. Results: In this retrospective study, 35 patients were reviewed. A description of middle ear malformation was proposed that considers ear embryogenesis and focuses on stapes deformity, with the main purpose of facilitating surgical approach selection to reconstruct the ossicular chain. Patients were classified into 3 categories: type I (19 cases), mobile stapes footplate, which included type Ia with normal stapes suprastructure and type Ib with abnormal stapes suprastructure; type II (4 cases), fixed stapes footplate, which included type IIa with normal ossicular chain and type IIb with abnormal ossicular chain; and type III (12 cases), oval window bony atresia or aplasia, with or without round window atresia. Types II and III could have concomitant aberrant facial nerve. Different surgical approaches are described. Conclusions: The authors describe the different types of congenital middle ear malformations. This category description considers ear embryogenesis and is focused on stapes deformity. It may provide better understanding of disease development and guide modern hearing reconstructive surgery.

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