scholarly journals Fibrous Dysplasia of the Temporal Bone with External Auditory Canal Stenosis and Secondary Cholesteatoma

2016 ◽  
Vol 12 (1) ◽  
pp. 125-128 ◽  
Author(s):  
Yu Hsi Liu ◽  
Kuo Ping Chang
2020 ◽  
pp. 014556132092792
Author(s):  
Kun Zhang ◽  
Peng Qu ◽  
Bing Wang ◽  
Endong Zhang ◽  
Bing Chen

Objective: This article summarizes the experience of diagnosis and treatment of temporal bone fibrous dysplasia (FD) with external auditory canal (EAC) stenosis and secondary cholesteatoma in the Chinese population, in order to improve the quality of life of patients in the future. Methods: Eleven patients with FD of the temporal bone who underwent surgery were retrospectively reviewed. Results: All lesions originated from the temporal bone, and all involved of the EAC. There were 11 cases of cholesteatoma in the EAC, 4 cases of cholesteatoma in the middle ear. The most common symptoms were hearing loss (100%), tinnitus (36.4%), and otorrhea (36.4%). Two patients were severe-profound sensorineural hearing loss, and one patient was complicated with subperiosteal abscesses. All 11 patients underwent surgery. There were no perioperative complications in this series and median follow-up time was 4.2 years. Conclusion: Temporal bone FD remains a rare diagnosis, especially in the Asian population. The lesions mainly lead to stenosis of the EAC, especially at the osteochondral junction. Cholesteatoma is the main complication of this disease, which is secondary to occlusion of the EAC with the growth of the lesion. Canaloplasty of EAC combined with wide meatoplasty can provide excellent prognosis in most cases.


Author(s):  
Manju Silu ◽  
Gaurav Gupta

<p class="abstract">Benign disease of bone marrow in which marrow is reorganize into fibrous tissue and immature woven bone, is known as fibrous dysplasia. Involvement of temporal bone is rare and can be isolated or in monostotic or polystotic form with various otologic manifestations. We are here reporting a case of fibrous dysplasia of the unilateral temporal bone who presented with hearing loss and stenosis of the external auditory canal. External auditory canal stenosis due to fibrous dysplasia was managed with canalplasty and patient was free of recurrence till last follow up. Fibrous dysplasia of isolated temporal bone is a rare entity which requires high grade of suspicion in a patient who presents with unusual bony swellings in the ear. Its management usually includes resection of the most affected part of temporal bone in order to achieve auditory canal patency and restoration of hearing. After surgery, a close follow up is warranted due to its propensity of recurrence.</p>


2021 ◽  
Vol 20 (1) ◽  
pp. 93-101
Author(s):  
S. D. Polyakova ◽  
◽  
T. S. Khegai ◽  
N. N. Bateneva ◽  
E. A. Nekrasova ◽  
...  

The authors give historical reference to the first documentary descriptions of the clinical, radiological, microscopic images of altered bones characteristic of such a rare disease as fibrous dysplasia (FD). FD is caused by a congenital mutation of the GNAS1 gene, which leads to the formation of a fibrous disorganized bone matrix with primitive bone tissue that is not able to mature into lamellar bones. Monossal, polyossal forms of FD are distinguished, as well as multiple bone damage with pigmentation and endocrine abnormalities. In FD, skull bones are usually affected (in order of decreasing frequency): frontal, sphenoid, ethmoid, parietal, temporal and occipital bones. An enlargement in the size of the temporal bone leads to the development of stenosis of the external auditory canal, which is clinically manifested by bleeding from the ear, conductive hearing loss, as well as the development of cholesteratoma. A clinical case of a patient with bilateral localization of temporal bone FD and unilateral clinical manifestation on the left (stenosis of the external auditory canal and secondary cholesteatoma) is presented. At the age of 18, the patient was operated on for the exostosis of the auditory canal in the ENT department of the city hospital, which did not prevent further progression of the disease. After 10 years, the subtotal stenosis of the left auditory canal again developed, which was the reason for the re-operation. The patient underwent surgical treatment followed by dynamic observation and computed tomography of temporal bones for 10 years.


2015 ◽  
Vol 30 (2) ◽  
pp. 65-66
Author(s):  
Ian C. Bickle

  This young adult man presented to ENT clinic with a complaint of left facial weakness and persistent left retro-auricular pain. High resolution CT of the mastoids was performed following clinical assessment. In this case, there is extensive sclerotic bony expansion with a ground-glass appearance involving the left zygoma, sphenoid and petrous temporal bone. The bony expansion is centred on the medullary bone and has an abrupt zonal transition (Figure 1).  The bone involvement encompasses almost complete bony stenosis of the left external auditory meatus down to 1-2mm with consequential fluid in the external auditory canal and middle ears (Figure 2). The bony expansion involves both the tympanic and mastoid segments of the facial canal which are stenosed.  The ossicular chain remains intact.  The left mastoid air cells are under-pneumatised and completely occupied by fluid. DISCUSSION Fibrous dysplasia (FD) is a benign congenital process that typical manifests itself as a localized defect in osteoblastic differentiation and maturation. Normal bone is replaced with haphazard fibrous tissue and immature woven bone.1 Fibrous dysplasia is predominantly a condition of children and young adults (those less than 30 years of age).  Disease growth usually halts after the third decade of life. FD may be a monostotic or polyostotic in nature and in some cases is part of a syndrome, such as McCune-Albright.2 The zygomatic maxillary complex is the most commonly reported location for fibrous dysplasia.  The temporal bone is a typical site in polyostotic disease, in up to 70%, but less often observed in monoostotic disease.  Disease of the temporal bone most typically results in hearing impairment due to bony stenosis of the external auditory canal. Facial nerve involvement is a less frequent feature, resulting in facial nerve paralysis, due to involvement of the nerve as it exits through the petrous temporal bone.2 The anatomical location of the facial nerve compression is hard to access and treat surgically.3 CT is the imaging investigation of choice giving the most exquisite bony definition.  Typical CT features (as shown in this case) are: A diffuse ground-glass appearance to the affected bone Homogeneously sclerotic bone Well-defined borders between the diseased and unaffected bone (abrupt zone of transition) Bony expansion, with overlying cortical bone intact The CT appearances apply equally to the anatomical site involved, however the combination of imaging appearances can be variable presenting a diagnostic dilemma, which may merit a confirmatory bone biopsy.


Sign in / Sign up

Export Citation Format

Share Document