Subtotal Petrosectomy With Preservation of Chorda Tympani for Petrous Bone Cholesteatoma: Case Report

A petrous bone cholesteatoma (PBC) is a rare epidermoid cyst of the petrous portion of the temporal bone. The main treatment is subtotal petrosectomy (SP), which generally involves sacrificing the chorda tympani. We report a case of extensive supralabyrinthine PBC in an elderly patient undergoing hemodialysis that was treated by SP with anatomical preservation of the chorda tympani. To the best of our knowledge, preservation of the chorda tympani during SP has not been previously reported. For maintenance of postoperative taste and appetite, preservation of the chorda tympani is a meaningful maneuver whenever possible.

Endolymphatic Sac Tumor: A Rare Case

Endolymphatic sac tumor is rare, locally aggressive and non-metastasizing neoplasm arising from the endolymphatic sac of the petrous portion of the temporal bone. Most occur in adult and present with ipsilateral hearing loss. They can be sporadic or associated with Von-Hippel-Lindau disease. Patient with endolymphatic sac tumor should be screened for VHL disease. We report a case of 52-year-old female with dizziness and headache. Histopathology was consistent with typical features of endolymphatic sac tumor. This was confirmed by cytokeratin and EMA positivity and TTF-1 negativity. This case is presented for its rarity with only few cases reported.

Facial nerve: Essential aspects from the biomedical sciences

This article is a review of the anatomical literature about of the facial nerve. It has historical aspects, functional components, periphery route inside and outside of the petrous portion of the temporal bone. It describes the nerve branches and territories of innervation. It also describes its nervous connections to the brain`s stem, specifically to the pons, which is the cerebral center, where facial nerves’ motor and vegetative nucleus is located. The information presented here could be useful to students of medicine, dentistry and others health programs at level of undergraduate and postgraduate. In this article have been used known books of anatomy and neuroanatomy. It has been also used articles of the last five years written by professional in neurosurgery, otorhinolaryngology and morphology. This article presents a correlation among the facial nerve anatomy and its implications in pathology, trauma and surgery of head and neck region.

Endoscopic endonasal translacerum approach to the inferior petrous apex

OBJECT The surgical approach to lesions involving the inferior petrous apex (IPA) is still challenging. The purpose of this study is to demonstrate the anatomical features of the IPA and to assess the applicability of an endoscopic endonasal approach through the foramen lacerum (translacerum approach) to the IPA. METHODS The surgical simulation of the endoscopic endonasal translacerum approach was conducted in 3 cadaver heads. The same technique was applied in 4 patients harboring tumors involving the IPA (3 chordomas and 1 chondro-sarcoma). RESULTS By removing the fibrocartilaginous component of the foramen lacerum, a triangular space was created between the anterior genu of the petrous portion of the carotid artery and the eustachian tube, through which the IPA could be approached. The range of the surgical maneuver reached laterally up to the internal auditory canal, jugular foramen, and posterior vertical segment of the petrous portion of the carotid artery. In clinical application, the translacerum approach provided sufficient space to handle tumors at the IPA. Gross-total and partial removal was achieved in 3 and 1 cases, respectively, without permanent surgery-related morbidity and mortality. CONCLUSIONS The endoscopic endonasal translacerum approach provides reliable access to the IPA. It is indicated alone for lesions confined to the IPA and in combination with other approaches for more extensive lesions.

Death and Disability in a Younge Phase Community

Roffelsen is an early Younge phase mortuary component in southwestern Ontario. The single burial feature is a pit containing the articulated skeletons of seven successively buried individuals, ranging in age from a few months to late middle age. All had been stripped of soft tissues, except for the connecting tissues that maintained their articulation. Most also had a disk cut from the cranium and a hole drilled near bregma. All but the infant display various forms of developmental failure of the outer and middle ear and the petrous portion of the temporal bone. The pit was apparently the burial facility for an extended family with significant hearing impairments. This disability may have limited their interaction with neighboring communities, perhaps even playing a role in their eventual disappearance as a separate community.

Aneurysmal Bone Cyst in the Temporal Bone and Complete Resection with Preoperative Embolization

We describe a rare case of aneurysmal bone cysts (ABCs) that occurred in the petrous portion of the temporal bone. The ABCs were treated with preoperative embolization and complete removal of the mass from the adjacent tissue. The technical details suggest that preoperative embolization is a good treatment option for ABCs.