Marrow-Mesenchyme Connections in the Fetal and Newborn Tympanum

1997 ◽  
Vol 106 (6) ◽  
pp. 466-470 ◽  
Author(s):  
Fred H. Linthicum ◽  
Qing Tian ◽  
William Slattery
Keyword(s):  
Middle Ear ◽  
Immunohistochemical Staining ◽  
Fibrous Tissue ◽  
Postnatal Period ◽  
Bacterial Invasion ◽  
Sinus Tympani ◽  
Stapedius Muscle ◽  
Microscopic Evaluation ◽  
Temporal Bones ◽  
Hematopoietic Bone Marrow

Examinations of 41 human fetal, 8 infant, and 8 juvenile temporal bones prepared for light microscopic evaluation revealed direct connections between the hematopoietic bone marrow and the unresolved mesenchyme in the middle ear. The connections first appeared at 15 weeks of gestation and became bridged by fibrous tissue, in most cases, by the postpartum age of 10 months. Between 16 and 18 months after birth, the marrow-mesenchyme connections gradually disappeared. The areas in which the connections were most numerous were the anterior epitympanum, the sinus tympani medial to the stapedius muscle, and transitory bone that occupies the area that will become the aditus of the antrum. Immunohistochemical staining demonstrated the existence of mature leukocytes in these connections. These connections may help protect the middle ear against bacterial invasion during the postnatal period.

scholarly journals Supratubal recess and sinus tympani: CT analysis of middle ear hidden areas

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Mohammad Waheed El-Anwar ◽  
Diaa Bakry Eldib ◽  
Ashraf Elmalt ◽  
Alaa Omar Khazbak
Keyword(s):  
Middle Ear ◽  
Preoperative Imaging ◽  
High Resolution Computed Tomography ◽  
Sinus Tympani ◽  
Ct Analysis ◽  
Length Width ◽  
Middle Ear Anatomy ◽  
Grade 3 ◽  
Temporal Bones ◽  
Ct Classification

Abstract Background High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed middle ear anatomy particularly its hidden area. The purpose of the current study was to assess the sinus tympani (ST) and supratubal recess (STR) by HRCT, to create CT classification of the STR depth, and to study the relationship between ST types and the new STR grades. Results In HRCT of non-pathological temporal bones of 100 subjects (200 ears), measurements of the STR and ST were calculated, registered, and analyzed. The depth of the STR was classified into grade 1 with depth less than 3 mm, grade 2 with depth ranged between 3 and 5 mm, and grade 3 with depth more than 5 mm. The mean STR length, width, and height were 4.17 ± 0.86, 3.55 ± 0.65, and 3.64 ± 0.7 mm, respectively, while the ST mean length and width of were 2.52 ± 0.5 and 1.82 ± 0.78 mm, respectively, without significant differences between either sexes or sided. The ST types were found to be type A in 56 ears (28%), type B in 142 ears (71%), and type C in 2 ears (1%). The STR grading was grade 1 in 12 ears (6%), grade 2 in 160 ears (80%), and grade 3 in 28 ears (14%) without significant relationship between ST types and STR grading (P = 0.3). Conclusion The current study provided reliable and applicable methods of CT assessment of STR and ST that can help to predict the degree of surgical visibility of the ST and STR during ear surgery.

scholarly journals Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

2021 ◽  
Author(s):  
Małgorzata Bilińska ◽  
Tomasz Wojciechowski ◽  
Jacek Sokołowski ◽  
Kazimierz Niemczyk
Keyword(s):  
Computed Tomography ◽  
Round Window ◽  
Optimal Placement ◽  
Facial Canal ◽  
Average Width ◽  
Sinus Tympani ◽  
Stapedius Muscle ◽  
Electrode Shape ◽  
Posterior Tympanotomy ◽  
Temporal Bones

Abstract Purpose Sinus tympani is the space in the retrotympanum, with variable morphology. Computed tomography is a common tool to investigate sinus tympani anatomy. During cochlear implantation or tympanoplasty, electrocochleography can be used for hearing monitoring. In such a surgical strategy the electrode is placed in the round window’s region throughout posterior tympanotomy. Common accessible needle-shaped electrodes using is difficult in achieving intraoperative stabilization. The aim of the study is to assess the dimensions and shape of sinus tympani, basing on the micro computed tomography scans for purposes of establishing the possible new electrocochleography electrode shape. Materials and methods Sixteen fresh frozen cadaveric temporal bones were dissected. MicroCT measurements included the depth and the width of sinus tympani, width of facial canal with stapedius muscle chamber. Obtained data were analyzed statistically with the use of RStudio 1.3.959 software. Results The highest average width of sinus tympani amounted for 2.68 mm, depth measured at the round window plane for 3.19 mm. Width of facial canal with stapedius muscle chamber highest average values at the round window plane- 3.32 mm. The lowest average minimum and maximum values were calculated at the 1 mm above the round window plane. The highest average posterior tympanotomy width was 2.91 mm. Conclusions The shape of the tympanic sinus is like a trough with the narrowest and deepest dimensions in the middle part. The ST shape and dimensions should be taken into account in constructing the ECochG electrode, designed for optimal placement through posterior tympanotomy approach.

R435 – Stapedius Muscle Relations to the Facial Canal

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P190-P190
Author(s):  
Alaa A. Abou-Bieh ◽  
Thomas J Haberkamp ◽  
Jarah Ali Al-Tubaikh
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Anatomical Variations ◽  
Surgical Anatomy ◽  
Facial Canal ◽  
Sinus Tympani ◽  
Stapedius Muscle ◽  
Facial Nerve Canal ◽  
Tendon Insertion ◽  
Temporal Bones

Problem The gross anatomical variations of the stapedius muscle and its relations to the facial nerve canal. Methods Thirty-five temporal bones were dissected, and the anatomic details were studied utilizing an operating microscope and otoendoscopes with 0o, 30o and 70o angles and 2.7 and 3 mm diameters. The muscle origin, its course in its bony sulcus with its relation to the facial nerve canal, the tendon and its insertion were studied. Results Marked variations in the origin, size, and course of the muscle in its bony sulcus were detected. The shape of the sulcus itself and its relation to the facial nerve canal varied also, both mainly influenced by the sinus tympani development. These variations affected the shape and length of the tendon and the pyramidal eminence. In addition, they influenced the site of tendon insertion into the stapes. The presence of ectopic muscle bundles was confirmed in one specimen. Conclusion The stapedius muscle anatomy can vary significantly from one temporal bone to another. In some situations these variations can be of surgical importance worse enough to be recognized. Significance To add important unrecognized data to the surgical anatomy of the temporal bone.

Mesenchyme Remaining in Human Temporal Bones

1986 ◽  
Vol 95 (3_part_1) ◽  
pp. 349-357 ◽  
Author(s):  
Tetsuo Takahara ◽  
Isamu Sando ◽  
Yoshie Hashida ◽  
Yoshihiro Shibahara
Keyword(s):  
Middle Ear ◽  
Round Window ◽  
Oval Window ◽  
The Body ◽  
First Year ◽  
Sinus Tympani ◽  
Hematoxylin And Eosin ◽  
Round Window Niche ◽  
Temporal Bones ◽  
Middle Ear Cleft

This study was conducted in order to gain basic information about mesenchyme remaining in the middle ear cleft in normal infants. Because no previous report has objectively described the quantity or quality of such postnatal remnants in normal infants, it has not been possible to accurately evaluate the significance of mesenchyme remaining in the middle ears of infants with pathologic conditions, such as otitis media and congenital anomalies. Thus, 53 temporal bones obtained from 41 individuals reported upon here—from 26 weeks' gestation to 8 years of age—will be controls for future studies of pathologic conditions. The children from whom these temporal bones were obtained had no anomalies of the ear (or any other known part of the body); nor did they have any pathologic conditions in the ear. The temporal bones were prepared for histologic study with hematoxylin and eosin staining and were examined under the light microscope. After areas of the mesenchyme in the histologic sections were projected and illustrated for each of 19 portions in the middle ear cleft under the microprojector, those areas were measured by compensating polar planimetry. The findings obtained in this study were as follows: (1) The amount of mesenchyme remaining in the days after birth seemed to gradually decrease in volume with increased maturity and had nearly disappeared within the first year in normal infants. Where mesenchyme was noted in the temporal bones of infants over 1 year of age, it was usually present only in small niches. (2) Most mesenchyme found in temporal bones of normal infants was seen in the mastoid antrum; it was also found in the aditus ad antrum, the epitympanum, the hypotympanum, the sinus tympani, the round window niche, the oval window niche, and the mesotympanum.

R447 – Temporal Bone Histopathology in Acute Lymphocytic Leukemia

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P194-P194
Author(s):  
Kyoichi Terao ◽  
Sebahattin Cureoglu ◽  
Schachern Patricia ◽  
Michael M Paparella ◽  
Norimasa Morita ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Middle Ear ◽  
Acute Lymphocytic Leukemia ◽  
Fibrous Tissue ◽  
Lymphocytic Leukemia ◽  
Common Finding ◽  
Petrous Apex ◽  
Vestibular Labyrinth ◽  
Temporal Bones

Problem There are reports of hearing loss, tinnitus, and/or vertigo in patients with leukemia. However, there is no human temporal bone study of a large number of cases specific to acute lymphocytic leukemia. We studied the correlation between clinical otologic complaints and temporal bone histopathology in patients with this disease. Methods Clinical otologic complaints and histologic findings were evaluated in 13 patients (25 temporal bones) with acute lymphocytic leukemia. Results Nine patients had a history of clinical otologic complaints including: hearing loss in 5 patients; otalgia in 3; otorrhea in 3; and dizziness in 2. Hemorrhage was seen most commonly in the middle ear in 10 patients, but was also evident in the cochlea in 5 and the vestibular labyrinth in 2. Leukemic infiltration was observed in the petrous apex in 12 patients, in the middle ear in 6, the cochlea in 5, the vestibular labyrinth in 2 and the internal auditory canal in 3. Inflammatory cell infiltration was also seen in the cochlear labyrinth in 4 patient, the vestibular labyrinth in 5 and the modiolus in 1. Otitis media with hyperplasia of subepithelial fibrous tissue was seen in 10 patients. Three patients had granulation tissue extending into the middle ear or mastoid. Conclusion Ear involvement is a common finding in patients with acute lymphocytic leukemia. Significance With prolonged survival due to new chemotherapeutics, the diagnosis and treatment of non-hematopoietic system complications such as ear problems due to acute lymphocytic leukemia have become more important. Support International Hearing Foundation, Hubbard Foundation, Starkey Foundation.

Dimensions of the Sinus Tympani and its Surgical Access VIA a Retrofacial Approach

1996 ◽  
Vol 105 (10) ◽  
pp. 776-783 ◽  
Author(s):  
Orhan Ozturan ◽  
Charles C. Miller ◽  
Carol A. Bauer ◽  
Herman A. Jenkins
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Middle Ear ◽  
Surgical Approaches ◽  
Sinus Tympani ◽  
Surgical Access ◽  
Extensive Evaluation ◽  
Temporal Bones ◽  
A Site ◽  
Anatomic Region

The sinus tympani (ST) is a critical anatomic region of the temporal bone. It lies medial to the facial nerve, between the ponticulus and the subiculum, and therefore is not easily visualized by routine surgical approaches to the middle ear and mastoid. This limited access makes the ST a site that is notorious for residual cholesteatoma. An extensive evaluation of the anatomic dimensions of the ST was made from human temporal bones. Three hundred twenty-seven bones were examined at four standardized levels to describe the dimensions and anatomic relationships of the ST with other structures of the temporal bone. The region of the stapedial tendon was found to be the most limited anatomic substructure in the vicinity of the ST. This study demonstrates the feasibility of a retrofacial approach to the ST as an aid in eradication of otherwise hidden disease.

Otopathologic Abnormalities in CHARGE Syndrome

2021 ◽  
pp. 019459982110089
Author(s):  
Rafael da Costa Monsanto ◽  
Renata Malimpensa Knoll ◽  
Norma de Oliveira Penido ◽  
Grace Song ◽  
Felipe Santos ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Middle Ear ◽  
Spiral Ganglion ◽  
Internal Auditory Canal ◽  
Semicircular Canals ◽  
Charge Syndrome ◽  
University Of Minnesota ◽  
Bony Canal ◽  
Ganglion Neurons ◽  
Temporal Bones

Objective To perform an otopathologic analysis of temporal bones (TBs) with CHARGE syndrome. Study Design Otopathologic study of human TB specimens. Setting Otopathology laboratories. Methods From the otopathology laboratories at the University of Minnesota and Massachusetts Eye and Ear Infirmary, we selected TBs from donors with CHARGE syndrome. These TBs were serially sectioned at a thickness of 20 µm, and every 10th section was stained with hematoxylin and eosin. We performed otopathologic analyses of the external ear, middle ear (middle ear cleft, mucosal lining, ossicles, mastoid, and facial nerve), and inner ear (cochlea, vestibule, internal auditory canal, and cochlear and vestibular nerves). The gathered data were statistically analyzed. Results Our study included 12 TBs from 6 donors. We found a high prevalence of abnormalities affecting the ears. The most frequent findings were stapes malformation (100%), aberrant course of the facial nerve (100%) with narrow facial recess (50%), sclerotic and hypodeveloped mastoids (50%), cochlear (100%) and vestibular (83.3%) hypoplasia with aplasia of the semicircular canals, hypoplasia and aplasia of the cochlear (66.6%) and vestibular (91.6%) nerves, and narrowing of the bony canal of the cochlear nerve (66.6%). The number of spiral ganglion and Scarpa’s ganglion neurons were decreased in all specimens (versus normative data). Conclusions In our study, CHARGE syndrome was associated with multiple TB abnormalities that may severely affect audiovestibular function and rehabilitation.

Tympanometry Revealing Middle Ear Pathology

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 209-215 ◽  
Author(s):  
Ulf Renvall ◽  
Jörgen Holmquist
Keyword(s):  
Middle Ear ◽  
Pure Tone ◽  
Screening Method ◽  
Initial Study ◽  
Predisposing Factor ◽  
Pilot Studies ◽  
Impedance Audiometry ◽  
Middle Ear Pressure ◽  
Stapedius Reflex ◽  
Temporal Bones

In order to evaluate the usefulness of impedance audiometry as a screening method for school children, two different pilot studies were performed. The results indicated that impedance audiometry (tympanometry and stapedius reflex test) was more efficient than otoscopy and pure tone screening in the detection of ears with secretory otitis media (SOM). In order to gain some more experience, an extended study of 800 7-year-olds was performed. The results from this investigation showed 6.5% pathological values with pure tone screening, 13.5% pathological values with tympanometry and 32% elevated or nonelicitable stapedius reflexes. Analysis of our observations indicates that the stapedius reflex may be too sensitive a test to be used as a screening method. Tympanometry, however, is recommended as a complement to pure tone screening in screening of children. A 6–12 months follow-up was also performed on 357 ears in which an initial study had shown a middle ear pressure of ≤ −100 mm H2O. At the repeated test 20% had pathological pure tone screening, 40% had a middle ear pressure of ≤ −100 mm H2O, 57% had elevated or nonelicitable stapedius reflexes, and 14% had middle ear effusion. The high frequency of persisting abnormal middle ear pressure and effusion in these 357 ears suggests that a middle ear pressure of ≤ −100 mm H2O can be a predisposing factor for SOM. In an experimental study on human temporal bones it was demonstrated that the tympanogram preserves its original appearance when the water level is low in the middle ear, while a higher level gives rise to a pathological tympanogram. It is also demonstrated that there is a discrepancy between the tympanometrically, indirectly recorded middle ear pressure and the middle ear pressure as measured manometrically, directly from the middle ear.

scholarly journals Histopathology of the Human Inner Ear in the Cogan Syndrome with Cochlear Implantation

2017 ◽  
Vol 22 (2) ◽  
pp. 116-123 ◽  
Author(s):  
Takefumi Kamakura ◽  
Daniel J. Lee ◽  
Barbara S. Herrmann ◽  
Joseph B. Nadol Jr.
Keyword(s):  
Bone Formation ◽  
Cochlear Implantation ◽  
Fibrous Tissue ◽  
Spiral Ganglion ◽  
New Bone Formation ◽  
Cogan Syndrome ◽  
Interstitial Keratitis ◽  
The Right ◽  
Ganglion Neurons ◽  
Temporal Bones

The Cogan syndrome is a rare disorder characterized by nonsyphilitic interstitial keratitis and audiovestibular symptoms. Profound sensorineural hearing loss has been reported in approximately half of the patients with the Cogan syndrome resulting in candidacy for cochlear implantation in some patients. The current study is the first histopathologic report on the temporal bones of a patient with the Cogan syndrome who during life underwent bilateral cochlear implantation. Preoperative MRI revealed tissue with high density in the basal turns of both cochleae and both vestibular systems consistent with fibrous tissue due to labyrinthitis. Histopathology demonstrated fibrous tissue and new bone formation within the cochlea and vestibular apparatus, worse on the right. Severe degeneration of the vestibular end organs and new bone formation in the labyrinth were seen more on the right than on the left. Although severe bilateral degeneration of the spiral ganglion neurons was seen, especially on the right, the postoperative word discrimination score was between 50 and 60% bilaterally. Impedance measures were generally higher in the right ear, possibly related to more fibrous tissue and new bone found in the scala tympani on the right side.

Experimental Stapedectomy

1977 ◽  
Vol 86 (4_suppl) ◽  
pp. 1-39 ◽  
Author(s):  
Gary K. Thomas
Keyword(s):  
Bone Formation ◽  
Otitis Media ◽  
Endolymphatic Hydrops ◽  
Blood Clot ◽  
Fibrous Tissue ◽  
Oval Window ◽  
New Bone Formation ◽  
Temporalis Fascia ◽  
In Series ◽  
Temporal Bones

This animal experimental study (144 cats) was designed to allow observation of the healing processes at the oval window following stapedectomy during the first two postoperative weeks. The first 61 animals (Series I) had no oval window cover except for a blood clot which might form spontaneously. The second 64 animals (Series II) had Gelfoam® as a cover to the oval window following stapedectomy. A third series of 19 animals had temporalis fascia used as the oval window cover, and these ears were studied histologically for up to nine weeks. The unoperated ear acted as a control for the operated ear in all animals and after the animals were killed, both temporal bones were decalcified, imbedded in celloidin, serially sectioned at 20μ, and every tenth section stained and mounted for histologic study. It was observed that oval window closure was effected by endosteal, periosteal, and fibrous tissue proliferation from the traumatized tissues about the oval window fenestra, and that this process was facilitated by the presence of some type of scaffolding material such as a blood clot or Gelfoam®. Temporalis fascia placed in the oval window was observed to be rapidly incorporated into a much thicker oval window neomembrane and to seal the fenestra promptly. Partial removal of the footplate also facilitated more rapid closure of the smaller oval window fenestra, but fibrous tissue and new bone formation was noted to form about bony fragments still attached at the oval window level. Free bony fragments within the vestibule were not observed to stimulate new bone formation. Suppuration was observed most frequently in Series I (no oval window cover), with 67.8% of these animals having some degree of otitis media. In Series II (Gelfoam® cover) 20.6% had otitis media, and in Series III (temporalis fascia) 21% had middle ear infection. Suppuration markedly impaired but did not completely prevent the oval window reparative processes. Animals having some type of oval window cover were noted to have a lesser incidence of suppurative labyrinthine involvement when otitis media was present. Other labyrinthine complications were observed, including endolymphatic hydrops, Wittmaack's hypotonic atrophy, as well as RBC, fibrin, and albuminous precipitates in the labyrinth. Hypotonic atrophy was observed in a high incidence of animals having rupture of one or more endolymphatic structures, suggesting a mechanical mechanism as one possible explanation for this condition. Hypotonic atrophy may represent the end-stage (collapse) in the fluctuant endolymphatic ballooning of hydrops which is seen when saccular or Reissner's membrane ruptures have occurred.

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