Post-traumatic temporal bone pneumatocele presenting after aggressive Valsalva

2021 ◽  
Vol 14 (12) ◽  
pp. e242607
Author(s):  
Jacob Seicshnaydre ◽  
Isaac Erbele ◽  
Stephen Hernandez ◽  
Moisés Arriaga
Keyword(s):  
Temporal Bone ◽  
Middle Ear ◽  
Bone Erosion ◽  
Full Thickness ◽  
Middle Ear Pressure ◽  
Traumatic Fracture ◽  
Post Traumatic ◽  
Sinus Pressure

We report a case of a temporal bone pneumatocele with full-thickness erosion of the cranium associated with aggressive nose blowing. This condition presented 9 years after traumatic fracture of the temporal bone. There are 17 reported cases of mastoid sinus hyperpneumatisation in the literature. Eleven of the 17 are associated with Valsalva manoeuvres or elevated middle ear pressure. However, no other cases of full-thickness erosion at the site of a former fracture have been reported. We propose that the fracture, in combination with elevated mastoid sinus pressure from aggressive nose blowing, led to escape and trapping of pressurised air in the epidural and subcutaneous spaces, which resulted in bone erosion.

Relation between temporal bone pneumatisation and middle-ear barotrauma in aircrew members

2019 ◽  
Vol 133 (10) ◽  
pp. 918-922
Author(s):  
A Hussein ◽  
H M Abdel Tawab ◽  
W T Lotfi ◽  
N Fayad ◽  
N Elsisy
Keyword(s):  
Temporal Bone ◽  
Middle Ear ◽  
Potential Role ◽  
Eustachian Tube Function ◽  
Middle Ear Pressure ◽  
Tube Function ◽  
Group A ◽  
Group B ◽  
Air Cells

AbstractObjectiveThis study aimed to assess the potential role of pneumatisation of the mastoid and its communicating air cells in the development of middle-ear barotrauma in aircrew members.MethodsSeventy-nine aircrew members (158 ears) underwent temporal computed tomography. All were assessed before flying by clinical examination and audiology evaluation, followed by post-flight examination to detect barotrauma.ResultsAircrew members’ ears were divided into 3 groups based on barotrauma and temporal bone pneumatisation: 33 ears with barotrauma and temporal bone pneumatisation of 71 cm3 or greater (group A); 12 ears with barotrauma and temporal bone pneumatisation of 11.2 cm3 or lower (group B); and 113 ears with no barotrauma (group C). Mean pneumatisation volumes were 91.05 cm3, 5.45 cm3 and 28.01 cm3 in groups A, B and C, respectively. A direct relationship was observed between volume of temporal bone pneumatisation of 71 cm3 or greater and barotrauma grade.ConclusionPneumatisation volume of the mastoid and its communicating air cells that ranges from 11.3 cm3 to 70.4 cm3 serves as a reliable predictor of the avoidance of middle-ear barotrauma associated with flying in aircrew members who have normal resting middle-ear pressure and good Eustachian tube function.

Cholesterol Granuloma Involving the Temporal Bone

1976 ◽  
Vol 85 (2) ◽  
pp. 204-209 ◽  
Author(s):  
George T. Nager ◽  
Theodore S. Vanderveen
Keyword(s):  
Temporal Bone ◽  
Middle Ear ◽  
Bone Erosion ◽  
Tissue Response ◽  
Cholesterol Granuloma ◽  
Cholesterol Crystals ◽  
Tubal Blockage ◽  
Serous Otitis Media ◽  
Rare Instance ◽  
Ear Effusion

The cholesterol granuloma does not represent an independent clinical or pathological entity, rather it is a term used for the description of a tissue response of the temporal bone, to the presence of a particular foreign body, i.e., cholesterol crystals. Three factors are considered to play an important role in its development: 1) interference with drainage, 2) hemorrhage, and 3) obstruction of ventilation. The cause of the initial hemorrhage may be a hemorrhagic inflammation or diathesis, a trauma or some other form of vascular disorder. Interference with air exchange and clearance can be caused by: tubal blockage, persistent mesenchyme, polypoid changes, scar formations, tympanosclerosis, cholesteatoma, etc. The cholesterol granuloma may develop in any portion of the pneumatic system of the temporal bone and it can be associated with a variety of middle ear disorders. Its principal precursor is the chronic middle ear effusion or serous otitis media. Its clinical expression and hallmark is the “idiopathic hematotympanum,” the dark bluish discoloration of the tympanic membrane. Osteitis and bone erosion are manifestations of an unusual, more advanced stage. Resorption of bone, in a rare instance, may lead to extensive destruction of the temporal bone.

A comparison of high resolution CT scan of temporal bone and operative findings in middle ear cholesteatoma

1993 ◽  
Vol 29 (5) ◽  
pp. 896
Author(s):  
Tae Beom Kweon ◽  
Hun Seong ◽  
Mal Soon Cheon ◽  
Hack Jin Kim ◽  
Keung Jae Jang ◽  
...  
Keyword(s):  
High Resolution ◽  
Ct Scan ◽  
Temporal Bone ◽  
Middle Ear ◽  
High Resolution Ct ◽  
Middle Ear Cholesteatoma ◽  
Operative Findings

Proof of concept study using a modified Politzer inflation device as a rescue modality for treating Eustachian tube dysfunction during hyperbaric oxygen treatment in a multiplace (Class A) chamber

2019 ◽  
pp. 55-61
Author(s):  
Owen J. O’Neill ◽  
Elizabeth Smykowski ◽  
Jo Ann Marker ◽  
Lubiha Perez ◽  
drah Gurash ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Tube Placement ◽  
Treatment Schedule ◽  
Surgical Interventions ◽  
Hyperbaric Treatment ◽  
Middle Ear Pressure ◽  
Tube Dysfunction

Introduction: Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEB) are the most common adverse effects of hyperbaric oxygen (HBO2) treatments. Patients practice equalization maneuvers to prevent ETD and MEB prior to hyperbaric exposure. Some patients are still unable to equalize middle ear pressure. This ETD results in undesirable consequences, including barotrauma, treatment with medications or surgical myringotomy with tube placement and interruption of HBO2. When additional medications and myringotomy are employed, they are associated with additional complications. Methods: A device known as the Ear Popper® has been reported to reduce complications from serous otitis media and reduce the need for surgical interventions (myringotomy). Patients unable to equalize middle ear pressure during initial compression in the hyperbaric chamber were allowed to use the device for rescue. All hyperbaric treatments were compressed using a United States Navy TT9, or a 45-fsw hyperbaric treatment schedule. Patients with persistent ETD and the inability to equalize middle ear pressure were given the Ear Popper upon consideration of terminating their treatment. Results: The Ear Popper allowed all patients to successfully equalize middle ear pressure and complete their treatments. Conclusion: This study substantiates the use of this device to assist in allowing pressurization of the middle ear space in patients otherwise unable to achieve equalization of middle ear pressure during HBO2 treatment in a multiplace chamber.

scholarly journals Micro-CT imaging of Thiel-embalmed and iodine-stained human temporal bone for 3D modeling

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Sebastian Halm ◽  
David Haberthür ◽  
Elisabeth Eppler ◽  
Valentin Djonov ◽  
Andreas Arnold
Keyword(s):  
Soft Tissue ◽  
Temporal Bone ◽  
Middle Ear ◽  
3D Modeling ◽  
Soft Tissues ◽  
Ct Imaging ◽  
Micro Ct ◽  
Data Set ◽  
Iodine Staining ◽  
Tissue Structures

Abstract Introduction This pilot study explores whether a human Thiel-embalmed temporal bone is suitable for generating an accurate and complete data set with micro-computed tomography (micro-CT) and whether solid iodine-staining improves visualization and facilitates segmentation of middle ear structures. Methods A temporal bone was used to verify the accuracy of the imaging by first digitally measuring the stapes on the tomography images and then physically under the microscope after removal from the temporal bone. All measurements were compared with literature values. The contralateral temporal bone was used to evaluate segmentation and three-dimensional (3D) modeling after iodine staining and micro-CT scanning. Results The digital and physical stapes measurements differed by 0.01–0.17 mm or 1–19%, respectively, but correlated well with the literature values. Soft tissue structures were visible in the unstained scan. However, iodine staining increased the contrast-to-noise ratio by a factor of 3.7 on average. The 3D model depicts all ossicles and soft tissue structures in detail, including the chorda tympani, which was not visible in the unstained scan. Conclusions Micro-CT imaging of a Thiel-embalmed temporal bone accurately represented the entire anatomy. Iodine staining considerably increased the contrast of soft tissues, simplified segmentation and enabled detailed 3D modeling of the middle ear.

Chorda tympani nerve, may it have a role in stabilizing middle ear pressure?

2013 ◽  
Vol 80 (6) ◽  
pp. 726-727 ◽  
Author(s):  
V. Rinaldi ◽  
M. Cappadona ◽  
M. Gaffuri ◽  
S. Torretta ◽  
L. Pignataro
Keyword(s):  
Middle Ear ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Middle Ear Pressure

Anatomical Effects of Sudden Middle Ear Pressure Changes

1979 ◽  
Vol 88 (3) ◽  
pp. 368-376 ◽  
Author(s):  
A. Axelsson ◽  
J. Miller ◽  
M. Silverman
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Round Window ◽  
Applied Pressure ◽  
Positive Pressure ◽  
Air Bubbles ◽  
Scala Tympani ◽  
Middle Ear Pressure ◽  
Contralateral Ear ◽  
Pressure Changes

Acute middle ear (ME) and inner ear changes following brief unilateral phasic ME pressure changes (up to ± 6000/mm H2O) were studied in the guinea pig. Middle ear findings included perforation of the tympanic membrane, serous and serosanguinous exudate and hemorrhage of tympanic membrane and periosteal vessels. Changes were related to magnitude of applied pressure. Perforation and hemorrhage were more commonly seen with negative rather than positive pressure. Air bubbles behind the round window were seen with positive pressures. Occasional distortion, but never perforation of the round window, was noted. Hemorrhage of the scala tympani was observed with both positive and negative pressures; scala vestibuli hemorrhage was found with negative ME pressure. In some instances pressure direction and magnitude related changes were seen in the contralateral ear.

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