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Surgical and Radiologic Anatomy : SRA Jun 2019Körner's septum (KS) is a developmental remnant formed at the junction of mastoid and temporal squama, representing the persistence of the petrosquamosal suture. During...
PURPOSE OF THE STUDY
Körner's septum (KS) is a developmental remnant formed at the junction of mastoid and temporal squama, representing the persistence of the petrosquamosal suture. During mastoid surgery, it could be taken as a false medial wall of the antrum so that the deeper cells might not be explored. The aim of the study was to assess a Körner's septum prevalence and to analyze its topography.
METHODS
The study was performed on 80 sets of cone-beam computed tomography (CBCT) images of temporal bone (41 male, 39 female, 160 temporal bones). Körner's septum was identified and its thickness was measured on axial sections at three points: at the level of superior semicircular canal (SCC), at the level of head of malleus (HM) and at the level of tympanic sinus (TS).
RESULTS
KS was encountered at least in one point of measurements in 50 out of 80 sets of CBCT images (62.5%). The average thickness at the level of SCC was 0.87 ± 0.34 mm, at the level of HM was 0.99 ± 0.37 mm and at the level of TS was 0.52 ± 0.17 mm.
CONCLUSIONS
Körner's septum is a common structure in the temporal bone-air cell complex. It is more often encountered in men. In half of the patients, it occurs bilaterally. However, in most of the cases it is incomplete with anterior and superior portions being the most constant.
Topics: Adolescent; Adult; Aged; Anatomic Variation; Child; Cone-Beam Computed Tomography; Female; Humans; Male; Mastoid; Middle Aged; Petrous Bone; Young Adult
PubMed: 30539206
DOI: 10.1007/s00276-018-2149-3 -
Case Reports in Otolaryngology 2015Introduction. Congenital cholesteatoma is a pearly white mass that rarely originates from the mastoid process. Case Report. A 21-year-old male patient presented to our...
Introduction. Congenital cholesteatoma is a pearly white mass that rarely originates from the mastoid process. Case Report. A 21-year-old male patient presented to our department with severe right mastoid pain and postauricular fluctuant swelling for 23 days. There was no preceding history of ear complaints and examination showed a normal right ear drum. Emergency exploration of the mastoid process was done on the same day and revealed localized cholesteatoma limited only to the mastoid cavity. Conclusion. Despite a rarity, the mastoid process should be always put in mind as a site of origin for congenital cholesteatoma.
PubMed: 25960905
DOI: 10.1155/2015/305494 -
Archiwum Medycyny Sadowej I Kryminologii 2015Assessment of the usefulness of intravital lesions in the proximal attachment of the sternocleidomastoid muscle and the mastoid process of the temporal bone in... (Comparative Study)
Comparative Study
Searching for new features of intravitality of hanging based on macro- and microscopic evaluation of the proximal attachment of the sternocleidomastoid muscle and the mastoid process of the temporal bone.
AIM OF THE STUDY
Assessment of the usefulness of intravital lesions in the proximal attachment of the sternocleidomastoid muscle and the mastoid process of the temporal bone in medico-legal evaluation of death by hanging.
MATERIAL AND METHODS
The study material was obtained from the bodies of 35 people who died by hanging. The control group comprised specimens collected from 30 people who died of non-traumatic causes. The structures under study were examined macro- and microscopically. The basic change which could be recognized as a marker of intravitality of hanging was the presence of a macroscopically extensive blotchy area of abundant ecchymosis in the proximal muscle attachment, similar to that found in the distal attachment, and the presence of abundant diffuse intraosseous ecchymoses in the mastoid process.
RESULTS
None of the cases revealed any ecchymoses in the proximal attachment of the muscle that would be similar to those present in the distal attachment. Discolourations within the mastoid processes, macroscopically suggestive of extensive intraosseous effusions arising from the mechanism of stretching, were not confirmed by microscopic evaluation and occurred at the same frequency as in the control group. Limitations of the study were related to the method which involved sample collection by means of bone chisels, decalcification and preparation of specimens, which had an effect, for example, on the measurable evaluation of the degree of congestion.
CONCLUSIONS
The study has failed to provide convincing and unambiguous data on the usefulness of examining mastoid processes and proximal attachments of the sternocleidomastoid muscles during autopsy to determine the presence of intravitality features of hanging. A description of research methodology and its associated difficulties, e.g. with the interpretation of results, can also be useful for the planning of similar studies by other researchers.
Topics: Asphyxia; Facial Injuries; Facial Muscles; Forensic Pathology; Fractures, Bone; Humans; Hyoid Bone; Mastoid; Neck Injuries; Neck Muscles; Suicide
PubMed: 27003864
DOI: 10.5114/amsik.2015.58159 -
Journal of the American Board of Family... 2013This is the issue of successful behavioral interventions and international comparisons that support the need for better primary health care in the United States. Men's...
This is the issue of successful behavioral interventions and international comparisons that support the need for better primary health care in the United States. Men's preconception care is considered, and the issue rounds out with articles about the radiologic findings of fluid in the mastoid bone, sex of physicians and mortality rates, a diabetes drug review, and, as usual, some informative brief case reports.
Topics: Diabetes Mellitus; Humans; Male; Mastoid; Patient Care Team; Periodicals as Topic; Preconception Care; Primary Health Care; Radiography; United States
PubMed: 23471922
DOI: 10.3122/jabfm.2013.02.130010 -
Ear, Nose, & Throat Journal Aug 2021The aim of this study is to investigate the scutum-cochleariform process (CP) and scutum-promontorium distances according to the mastoid pneumatization condition.
OBJECTIVES
The aim of this study is to investigate the scutum-cochleariform process (CP) and scutum-promontorium distances according to the mastoid pneumatization condition.
METHODS
Two hundred temporal multidetector computed tomography scans (90 males and 110 females) were evaluated retrospectively. The scutum-CP and scutum-promontorium distances were measured. Facial canal dehiscence (FCD) in the tympanic segment and mastoid pneumatization were also evaluated.
RESULTS
The distances between scutum-CP and scutum-promontorium were not different between males and females and between right and left sides. Facial canal dehiscence in the tympanic segment was detected: 5.6% (right) and 7.8% (left) in males and 5.5% (right) and 10.0% (left) in females. Grade 4 (100%) pneumatization was detected mainly in 55.6% to 57.8% of the patients in both genders. Grade 0 (0%) pneumatization (sclerosis) was detected in 22.2% to 28.2% of both males and females. In more pneumatized mastoids, the scutum-CP and scutum-promontorium distances increased. In sclerotic mastoids, the scutum-CP and scutum-promontorium distances decreased. Facial canal dehiscence rates were not related to the mastoid pneumatization levels.
CONCLUSION
Cochleariform process is an important landmark to localize the tympanic segment of the facial canal. In sclerosed mastoids, scutum-CP and scutum-promontorium distances decreased. There was no relationship between FCD rates and mastoid pneumatization levels. It may be due to the development of FCD that occurs during the intrauterine period. In endoscopic and classic ear surgeries, mastoid pneumatization must be evaluated preoperatively to avoid facial nerve injuries.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anatomic Landmarks; Cochlea; Emphysema; Facial Nerve Injuries; Female; Humans; Intraoperative Complications; Male; Mastoid; Middle Aged; Multidetector Computed Tomography; Predictive Value of Tests; Preoperative Period; Retrospective Studies; Risk Assessment; Temporal Bone; Young Adult
PubMed: 31581825
DOI: 10.1177/0145561319879528 -
Ear, Nose, & Throat Journal Dec 2012A cadaveric study was performed to test the hypothesis that intact-canal-wall mastoidectomy (ICWM) with otoendoscopy allows for equal or better visualization of the...
A cadaveric study was performed to test the hypothesis that intact-canal-wall mastoidectomy (ICWM) with otoendoscopy allows for equal or better visualization of the middle ear cavity structures when compared with canal-wall-down mastoidectomy (CWDM) with microscopy. Ten temporal bones were prepared with a reversible canal-wall-down tympanomastoidectomy technique. Five anatomic sites in each middle ear cavity (lateral epitympanum, posterior crus of the stapes, the sinus tympani, eustachian tube orifice, and round window niche) were marked with paint. Two otolaryngologists blinded to the purpose of the study viewed the temporal bones with the microscope. Following replacement of the posterior canal walls, the bones were then viewed with a 30° and a 70° otoendoscope. All visualized paint marks for each viewing were recorded and compared. We found that ICWM with 30° or 70° otoendoscopy provided significantly better visualization of the sinus tympani than did CWDM (p ≤ 0.001). There was no significant difference among the three methods in visualization of the lateral epitympanum, posterior crus of the stapes, and round window niche. With respect to the eustachian tube orifice, one of the observers reported significantly better visualization with CWDM (p = 0.036). With adjunctive otoendoscopy, it is not necessary to remove the posterior canal wall to adequately visualize or remove disease from various areas of the middle ear cleft. The use of otoendoscopy during cholesteatoma surgery may allow for more frequent preservation of the posterior canal wall and reduced rates of residual cholesteatoma, given the equal or better visualization of the middle ear cavity.
Topics: Ear Canal; Ear, Middle; Endoscopy; Humans; Mastoid; Microscopy; Tympanic Membrane
PubMed: 23288818
DOI: 10.1177/014556131209101208 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jan 2020The clinical symptoms, imaging features and surgical treatment of congenital cholesteatoma are reported. The clinical data of 20 patients with congenital cholesteatoma...
The clinical symptoms, imaging features and surgical treatment of congenital cholesteatoma are reported. The clinical data of 20 patients with congenital cholesteatoma diagnosed and treated in our hospital from January 2016 to May 2018 were retrospectively analyzed, including the age of onset, clinical symptoms, signs, audiology, HRCT of temporal bone, surgical methods and so on. In 20 patients with congenital cholesteatoma, the clinical manifestations were hearing loss in the affected ears, including 5 cases with ear fullness and 4 cases with tinnitus. There were 13 cases of local yellow-white shadow of tympanic membrane, 5 cases of normal tympanic membrane and 2 cases of tympanic membrane bombe. Pure tone audiometry showed conductive deafness in 14 cases and mixed deafness in 6 cases. CT scan of temporal bone showed that 15 cases had pneumatic type of mastoid, 4 cases had diploectic type and 1 case had sclerostic type. There were 15 cases of interspersed flocculent shadow and 5 cases of mass shadow. Among the 20 cases of chronic otitis media with cholesteatoma, 6 have cholesteatoma in epitympanum, 4 in tympanic cavity, 3 in tympanic cavity and epitympanum, 2 in mastoid and tympanic antrum, 1 in mastoid, tympanic antrum and tympanic cavity, 1 in tympanic antrum, tympanic cavity and petrous apex, 1 in tympanic cavity, hypotympanum, posterior tympanum and ostium tympanicum tubae auditivae, 1 in aditus ad antrum, epitympanum and posterior tympanum, 1 in tympanic cavity, epitympanum and posterior tympanum. Intact canal wall mastoidectomy and tympanoplasty were performed in 7 cases, open mastoidectomy and tympanoplasty in 5 cases, middle ear exploration and tympanoplasty in 4 cases, atticotomy with reconstruction and tympanoplasty in 3 cases and subtotal temporal bone resection in 1 case. For patients with intact tympanic membrane presenting with hearing loss, the tympanic membranes should be carefully examined, and thin-section CT and MRI of temporal bone should be performed in time to avoid missed diagnosis of congenital cholesteatoma. Once diagnosed, surgery should be performed as soon as possible.
Topics: Cholesteatoma; Humans; Mastoid; Missed Diagnosis; Retrospective Studies; Treatment Outcome; Tympanic Membrane; Tympanoplasty
PubMed: 32086897
DOI: 10.13201/j.issn.1001-1781.2020.01.011 -
The Journal of International Advanced... Apr 2020Liposarcoma is a soft tissue neoplasm that commonly develops in the lower extremities and rarely in the head and neck region. Herein, we report the case of a patient...
Liposarcoma is a soft tissue neoplasm that commonly develops in the lower extremities and rarely in the head and neck region. Herein, we report the case of a patient with primary liposarcoma that was detected in the mastoid antrum during staged tympanoplasty for cholesteatoma. The tumor adjacent to the attic cholesteatoma was resected completely, and the pathological diagnosis was that of myxoid-type liposarcoma. Because positron emission tomography after the surgery showed no signs of tumor remnants or systemic metastasis, a second-stage surgery was performed 8 months after the first surgery. After confirming that there was no recurrence, tympanoplasty type III with interposition between the stapes and malleus and canal reconstruction was performed. No recurrence was observed for 5 years, and to date, good hearing has been maintained. This is the first report on long-term follow-up of a patient with liposarcoma in the mastoid antrum.
Topics: Aged; Aged, 80 and over; Child, Preschool; Cholesteatoma, Middle Ear; Hearing; Humans; Liposarcoma, Myxoid; Magnetic Resonance Imaging; Male; Mastoid; Mastoidectomy; Middle Aged; Positron-Emission Tomography; Postoperative Care; Treatment Outcome; Tympanoplasty
PubMed: 31257194
DOI: 10.5152/iao.2019.6709 -
Otology & Neurotology : Official... Feb 2021To systematically review the available medical literature to investigate the viral load in the middle ear and mastoid cavity and the potential risk of exposure to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review the available medical literature to investigate the viral load in the middle ear and mastoid cavity and the potential risk of exposure to airborne viruses during otologic surgery.
DATA SOURCES
PubMed, MEDLINE, and Cochrane databases.
STUDY SELECTION
This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocol.
DATA EXTRACTION
Using the Boolean method and relevant search term combinations for terms "mastoid," "middle ear," "virus," "exposure" "COVID-19" "SARS-CoV-2." PubMed, MEDLINE, and Cochrane databases were queried. A total of 57 abstracts were identified and screened by two independent reviewers. Following inclusion and exclusion criteria, 18 studies were selected for the final analysis.
DATA SYNTHESIS
Due to the heterogeneity of clinical data, a meta-analysis was not feasible.
RESULTS
Rhinovirus, followed by respiratory syncytial virus are reported to be the most prevalent viruses in MEF samples but formal statistical analysis is precluded by the heterogeneity of the studies. Drilling was identified to have the highest risk for aerosol generation and therefore viral exposure during otologic Surgery.
CONCLUSIONS
The medical literature has consistently demonstrated the presence of nucleic acids of respiratory viruses involving the middle ear, including SARS-CoV2 in a recent postmortem study. Although no in vivo studies have been conducted, due to the likely risk of transmission, middle ear and mastoid procedures, particularly involving the use of a drill should be deferred, if possible, during the pandemic and enhanced personal protective equipment (PPE) used if surgery is necessary.
Topics: COVID-19; Ear, Middle; Humans; Mastoid; Otologic Surgical Procedures; Pandemics; Viral Load
PubMed: 33201081
DOI: 10.1097/MAO.0000000000002986 -
The Annals of Otology, Rhinology, and... Nov 2021Acute neurological sequela in patients with COVID-19 infection include acute thromboembolic infarcts related to cytokine storm and post infectious immune activation...
BACKGROUND
Acute neurological sequela in patients with COVID-19 infection include acute thromboembolic infarcts related to cytokine storm and post infectious immune activation resulting in a prothrombotic state. Radiologic imaging studies of the sinonasal tract and mastoid cavity in patients with COVID-19 infection are sparse and limited to case series. In this report, we investigate the radiologic involvement of nasal cavity, nasopharynx, paranasal sinuses, and mastoid cavity in patients with SARS-CoV-2 infection who presented with acute neurological symptoms.
METHODS
Retrospective review of medical records and neuroradiologic imaging in patients diagnosed with acute COVID-19 infection who presented with acute neurological symptoms to assess radiologic prevalence of sinus and mastoid disease and its correlation to upper respiratory tract symptoms.
RESULTS
Of the 55 patients, 23 (42%) had partial sinus opacification, with no evidence for complete sinus opacification. The ethmoid sinus was the most commonly affected (16/55 or 29%). An air fluid level was noted in 6/55 (11%) patients, most commonly in the maxillary sinus. Olfactory recess and mastoid opacification were uncommon. There was no evidence of bony destruction in any of the studies, Cough, nasal congestion, rhinorrhea, and sore throat were not significantly associated with any radiological findings.
CONCLUSION
In patients who present with acute neurological symptoms, COVID-19 infection is characterized by limited and mild mucosal disease within the sinuses, nasopharynx and mastoid cavity.
LEVEL OF EVIDENCE
4.
Topics: COVID-19; Correlation of Data; Diagnostic Techniques, Neurological; Female; Humans; Magnetic Resonance Imaging; Male; Mastoid; Middle Aged; Nasopharynx; Neuroimaging; Neurologic Examination; New York; Paranasal Sinuses; Prevalence; SARS-CoV-2; Symptom Assessment; Tomography, X-Ray Computed
PubMed: 33569970
DOI: 10.1177/0003489421995070