Temporal bone meningoceles are uncommon malformations in which meninges protrude through a defect in the temporal bone while meningoencephalocele is a condition where brain tissue and meninges ...herniate through the bone defect. Bone defects can be acquired (trauma, surgery, tumor spread) or spontaneous (congenital).1 Spontaneous temporal bone meningoceles and meningoencephaloceles are unusual findings and may present with hearing loss, headache, otorrhea, and recurrent acute otitis media or rarely by otogenic meningitis or even cerebral abscess due to the thinness of tegmen tympani which separates the middle cranial fossa from the tympanic cavity. Small temporal bone meningoceles can be difficult to differentiate from other solid or cystic temporal bone mass on high-resolution computed tomography (CT). However, magnetic resonance imaging (MRI) with high-resolution sequences is able to depict meningoceles as it presents as a cerebrospinal fluid (CSF) collection. Magnetic resonance imaging also can show spontaneous CSF fistulas between the subarachnoid space and middle ear or a defect in the osseous labyrinth. Magnetic resonance imaging is the main imaging technique in assessing complications of middle ear infections leading to CSF fistulas, meningitis, or cerebral abscess formation.2
Hearing results after chronic ear surgery encompass recurrence, localization and extent of cholesteatoma, type of surgery, ossiculoplasty methods, but rarely interpret intraoperative findings. This ...study aimed to analyze the impact of intraoperative findings in revision tympanomastoidectomy in predicting postoperative hearing.
This was a retrospective non-randomized cohort of 101 patients treated for recurrent chronic otitis media by tympanomastoidectomy. The patients' demographics, localizations of disease recurrence and perioperative hearing results were analyzed.
Logistic regression showed that presence of tympanic perforation (p=0.036), ossicular chain damage (p=0.006), were negatively associated with improved hearing postoperatively. Attic cholesteatoma was associated with better postoperative hearing (p=0.045). Presence of tympanic perforation (p=0.050), alongside perifacial localization of imflammation (p=0.021) and ossicle destruction (p=0.013) were associated with worse postoperative hearing results. Multivariate analysis confirmed that tympanic perforation (p=0.040, F=4.401), and ossicular chain involvement (p=0.025, F=5.249), were consistent negative predictors of hearing improvement, while postoperative deterioration of hearing was associated with tympanic perforation (p=0.038, F=4.465) and facial nerve dehiscence (p=0.045, F=4.160).
Comparison of postoperative revision tympanomastoidectomy hearing outcomes revealed significant positive reductions in air-bone gap values, primarily at low and mid frequencies. Postoperative hearing results at high frequencies are not affected by revision surgery.
Salivary cortisone strongly correlates with serum cortisol, and since it is less invasive to measure salivary cortisone than serum cortisol and easier than to measure cortisol in saliva, as its ...concentrations are much lower, we wanted to compare salivary cortisone and cortisol levels as markers of noise-induced stress reaction. The study included 104 participants aged 19–30 years, 50 of whom were exposed to occupational noise ≥85 dB(A) and 54 non-exposed, control students. All participants took samples of their saliva with Salivette
Cortisol synthetic swabs on three consecutive working days first thing in the morning. Salivary cortisone and cortisol levels were determined with high-performance liquid chromatography. In addition, they completed a 10-item Perceived Stress Scale (PSS-10) questionnaire, and occupationally noise-exposed participants also completed the Health and Safety Executive (HSE) questionnaire on occupational psychosocial risks. The exposed participants had significantly higher cortisone (P<0.001) and cortisol (P<0.001) levels than controls, and the correlation between cortisone and cortisol levels in the exposed participants was strong (ϱ =0.692, P<0.001), which suggests that salivary cortisone can replace cortisol measurements in saliva as a more reliable method than salivary cortisol and less invasive than serum cortisol. However, the level of perceived stress scored on PSS-10 in the exposed participants did not differ significantly from stress reported by controls, but correlated negatively with cortisone levels, which is contrary to our expectations and raises questions as to why.
There is an increased number of people with hearing impairment and decreased cognitive abilities among the elderly population. Due to the fact that the auditory system and central nervous system are ...connected, pathological changes associated with aging occur on both levels. With the development of hearing aid technology, the quality of life of these patients can be improved. The aim of this study was to determine whether wearing a hearing aid has an impact on cognitive abilities and tinnitus. Current research does not show a clear connection between these factors. This study involved 44 subjects with sensorineural hearing loss. They were divided into two groups of 22 people, depending on whether they had previously used a hearing aid or not. Assessment of cognitive abilities was performed via the MoCA questionnaire, and assessment of the impact of tinnitus on daily activities was evaluated using the Tinnitus Handicap Inventory (THI) and the Iowa Tinnitus Handicap Questionnaire (ITHQ). Hearing aid status was classified as a primary outcome, while cognitive assessment and tinnitus intensity were associated variables. Our study showed an association between longer hearing aid use and poorer naming ability (p = 0.030, OR 4.734), poorer delayed recall (p = 0.033, OR 4.537), and spatial orientation (p = 0.016, OR 5.773) when compared with patients who had not used hearing aids, while tinnitus did not correlate with cognitive impairment. Based on the results, we can emphasize the importance of the auditory system as an input source for the central nervous system. The data direct us to improve the rehabilitation strategies for hearing and cognitive abilities in patients. Such an approach results higher quality of life in patients and prevents further cognitive decline.
Stapes surgery is generally performed to treat otosclerosis, and there are numerous surgical techniques and prosthesis materials available. Critical evaluation of postoperative hearing outcomes is ...crucial for identification and further improvement of treatment options. This study is a non-randomized retrospective analysis of hearing threshold levels before and after stapedectomy or stapedotomy in 365 patients during a twenty-year period. The patients were classified into three groups depending on the prosthesis and surgery type: stapedectomy with Schuknecht prosthesis placement and stapedotomy with either Causse or Richard prosthesis. The postoperative air-bone gap (ABG) was calculated by subtracting the bone conduction pure tone-audiogram (PTA) from the air conduction PTA. Hearing threshold levels were evaluated preoperatively and postoperatively from 250 Hz to 12 kHz. The results showed air-bone gap reduction <10 dB in 72% patients, 70% of patients, and 76% of patients using Schucknecht's prosthesis, Richard prosthesis, and Causse prosthesis, respectively. The results did not differ significantly between three prothesis types. Choice of prosthesis should be made individually for each patient, but surgeon competency is still the most important outcome variable, regardless of prosthesis type.
Primary Ameloblastoma of the Temporal Bone Košec, Andro, MD; Ajduk, Jakov, MD, PhD; Ries, Mihael, MD, PhD ...
Journal of oral and maxillofacial surgery,
06/2017, Letnik:
75, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Abstract Ameloblastoma is a locally aggressive tumor derived from odontogenic epithelium. Although benign, its clinical behavior may often times exhibit malignant characteristics. It is marked by ...slow and persistent growth with infiltration of adjacent tissues. Almost 70% occur in the mandible in patients over 30 years of age. Recurrence of ameloblastoma due to inadequate treatment is frequent. Due to its slow growth, recurrences may present decades after primary surgery. A primary ameloblastoma in an area outside of the mandible, maxilla and infratemporal fossa regions has not been described in detail to date, with only one possible case mentioned in literature. The authors present a case of primary temporal bone ameloblastoma in a 17-year-old male patient. The tumor originated in the left mastoid, infiltrating the lateral semicircular canal, facial nerve and cochlea, adhering to the sigmoid sinus and posterior cranial fossa dura. Although invasion of multiple structures in the infratemporal fossa and the temporal bone leads to variable disease presentation, this case is unique when considering that the first symptom of disease was unilateral recurring sensorineural sudden hearing loss. S urgery required transection of the facial nerve. Histopathology confirmed primary temporal bone ameloblastoma. The difficulties in achieving wide surgical margins, diagnostics and further management are also addressed.
We report a rare case of a large recurrent mucoepidermoid carcinoma (RMEC) in an 81-year-old female smoker, which has originated in the right nasal vestibule. The recurrent tumour was inadequately ...treated for 6 years. It was a slow-growing tumour for 3 years and then began to enlarge at a higher pace. In the next three years it has covered a large part of the face. The patient had refused any medical treatment. The tumour caused breathing and swallowing difficulties. Because of the profuse bleeding from the tumour, the patient underwent emergency surgery. Surgical treatment consisted of rhinectomy and resection of the central upper lip and part of the right cheek. The facial defect was reconstructed immediately. Recovery from surgery was fast with no complications. Postoperative Multislice Computed Tomography scan showed no metastases so the patient did not receive any chemotherapy or radiotherapy. During a 2.5 years’ follow-up period there was no recurrence of the disease.
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