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Marlan R. Hansen - One of the best experts on this subject based on the ideXlab platform.
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Temporal Bone carcinoma treatment patterns and survival
Laryngoscope, 2020Co-Authors: Kristen L Seligman, Daniel Q Sun, Patrick Ten Eyck, Nathan M Schularick, Marlan R. HansenAbstract:Objectives/hypothesis Carcinomas of the Temporal Bone are rare, and appropriate treatment, staging, and survival data are limited. This study evaluates clinical characteristics and survival rates for patients with Temporal Bone carcinoma treated with resection at a single tertiary-care institution, with a focus on the outcomes of patients with locally advanced disease including skull base and/or dural invasion. Study design Retrospective chart review. Methods Demographic, tumor-specific, and survival data were collected for patients with primary carcinomas of the external auditory canal with involvement of the Temporal Bone from 2003 to 2015. All patients were staged according to the modified Pittsburgh system. Kaplan-Meier and logistic regression analysis were used to calculate factor-specific survival outcomes. Results Sixty-seven patients met inclusion criteria; 85% were male. There were 43 squamous cell carcinomas (64%) and 24 basal cell carcinomas (BCCs) (36%). Tumor stage was 24 (36%) T2, 12 (18%) T3, and 31 (46%) T4 tumors; 53% had recurrent disease. Surgical management included 49 lateral Temporal Bone resections and 18 subtotal Temporal Bone resections. Kaplan-Meier analyses revealed more favorable 5-year survival rates associated with BCC histology (P = .01), lateral Temporal Bone resection compared to subtotal Temporal Bone resection (P Conclusions Factors predictive of more favorable survival include lack of immunocompromise, BCC histology, absence of perineural/lymphovascular invasion, and disease extent amenable to lateral Temporal Bone resection. Dural invasion is not an absolute contraindication to surgery, with a subset of patients surviving >5 years. Level of evidence 3 Laryngoscope, 130:E11-E20, 2020.
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Acute radiographic workup of blunt Temporal Bone trauma: maxillofacial versus Temporal Bone CT.
The Laryngoscope, 2009Co-Authors: Ryan Douglas Dempewolf, Samuel P. Gubbels, Marlan R. HansenAbstract:Objectives/Hypothesis: To evaluate the radiographic workup of blunt Temporal Bone trauma and determine the utility of maxillofacial computed tomography (CT) versus Temporal Bone CT in identifying carotid canal fractures. Study Design: Retrospective review. Methods: The charts of 227 patients evaluated at a level I trauma center receiving a Temporal Bone CT for blunt head trauma within 48 hours of admission were reviewed. Acute evaluation findings and complications were noted. Sensitivity, specificity, positive predictive value, and negative predictive (NPV) value were calculated for maxillofacial CT's ability to identify carotid canal fractures compared to Temporal Bone CT. Results: One hundred forty fractures were found. Physical exam findings of blood in the external auditory canal as the sole finding, and blood in the external auditory canal with associated hemotympanum were significantly associated with absence and presence of fracture respectively. The sensitivity and specificity of maxillofacial CT for identifying carotid canal fractures, when compared to Temporal Bone CT, were 90.3% and 94.4% respectively (NPV > 95%). Only 6% of all patients either did have or should have had their management changed based on the Temporal Bone CT findings. All of these changes were regarding further workup for blunt carotid artery injury. Conclusions: A combination of helical computed tomography and physical exam findings can allow for judicious use of Temporal Bone CTs when no maxillofacial CT is indicated. Temporal Bone CTs rarely change acute management. But when they do, it is in regard to the need for further workup of possible vascular injury. Lastly, maxillofacial CTs are adequate for identifying carotid canal fractures. Laryngoscope, 119:442–448, 2009
Joel W. Yeakley - One of the best experts on this subject based on the ideXlab platform.
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Temporal Bone fractures
Current problems in diagnostic radiology, 1999Co-Authors: Joel W. YeakleyAbstract:High-resolution technique is essential to the evolution of Temporal Bone fractures. Axial and coronal scan planes are optimal but may not be possible in acutely traumatized patients. A knowledge of normal Temporal Bone anatomy is important and can be obtained from standard texts, so it will not be considered in detail in this article. Classically, petrous Temporal Bone fractures have been classified as longitudinal, transverse, or mixed. Recent publications have emphasized the importance of describing fractures in terms of planes rather than lines. According to this concept, most Temporal Bone fractures are actually oblique, and true longitudinal fractures are rare. Petrous Temporal Bone fractures may be associated with cranial nerve or vascular injuries when the fracture extends to the skull base. This is particularly true of the oblique fracture, which characteristically extends anteromedially to the skull base through weak places in that area, thus avoiding the compact Bone of the otic capsule surrounding the labyrinth. The most common associated injury is to the facial nerve in its geniculate or proximal tympanic segment. Transverse fractures frequently involve the labyrinth. A careful search for various types of ossicular dislocation should be performed in association with Temporal Bone fractures, because this may result in conductive hearing loss. The site of cerebrospinal fluid otorhinorrhea resulting from Temporal Bone fractures can usually be defined on plain high-resolution Temporal Bone images, but intrathecal contrast may be helpful. Temporal Bone fractures caused by gunshot wounds are frequently complex and may be limited by metallic streak artifacts. Pediatric patients have different proportions of facial nerve injury and types of hearing loss as compared with adults.
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Temporal Bone fractures: longitudinal or oblique? The case for oblique Temporal Bone fractures.
Laryngoscope, 1992Co-Authors: Bechara Y. Ghorayeb, Joel W. YeakleyAbstract:Classical descriptions and illustrations of Temporal Bone fractures are misleading. Both oblique and longitudinal fractures produce a similar fracture line in the middle cranial fossa; however, externally, they are different. Oblique fractures cross the petrotympanic fissure while longitudinal fractures run within it. In a study of 150 Temporal Bone fractures, the majority were oblique. An array of fracture planes accounts for most of the fractures observed. Depending on the direction of trauma, fracture planes rotate around an anteroposterior axis. When they approach the horizontal (axial) plane, they result in oblique fractures. True longitudinal fractures are rare. They are vertical and perpendicular to the oblique planes.
Paul W. Gidley - One of the best experts on this subject based on the ideXlab platform.
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Temporal Bone resection for lateral skull-base malignancies
Journal of Neuro-Oncology, 2020Co-Authors: Gautam U. Mehta, Thomas J. Muelleman, Derald E. Brackmann, Paul W. GidleyAbstract:Introduction Malignancies involving the Temporal Bone are increasingly common and require specialized multi-disciplinary care. Given this complex location, involvement of the lateral skull base and local neurovascular structures is common. In this review we discuss general principles for Temporal Bone resection, as well as alternative and complementary surgical approaches that should be considered in the management of patients with Temporal Bone cancer. Methods A comprehensive review on literature pertaining to Temporal Bone resection was performed. Results The primary surgical strategy for malignancies of the Temporal Bone is Temporal Bone resection. This may be limited to the ear canal and tympanic membrane (lateral Temporal Bone resection) or may include the otic capsule and its contents (subtotal Temporal Bone resection), and/or the petrous apex (total Temporal Bone resection). Management of adjacent neurovascular structures including the facial nerve, the carotid artery, and the jugular bulb/sigmoid sinus should be considered during surgical planning. Finally, adjunctive procedures such as parotidectomy and neck dissection may be required based on tumor stage. Conclusions Temporal Bone resection is an important technique in the treatment of lateral skull-base malignancies. This strategy should be incorporated into a multi-disciplinary approach to cancer.
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Metastatic Lesions to the Temporal Bone
Temporal Bone Cancer, 2018Co-Authors: Paul W. Gidley, Marcelie NaderAbstract:Metastatic lesions to the Temporal Bone are relatively rare in clinical practice, but the Temporal Bone is often involved by metastatic disease in autopsy studies. The most common site for metastatic involvement is the petrous portion of the Temporal Bone. Breast, lung, prostate, melanoma, kidney, and stomach cancers are the most likely primary tumors to produce Temporal Bone metastases. Hearing loss, otorrhea, vertigo, and facial paralysis are the most common symptoms of Temporal Bone metastasis; however, a large proportion of metastatic lesions to the Temporal Bone are asymptomatic. In the patient with a history of malignant disease, the differential diagnosis should include metastasis when patients present with otologic complaints. Diagnostic imaging with CT and MRI, especially when combined with PET/CT or whole-body Bone scan, usually leads to the diagnosis. Surgical resection of metastatic disease in the Temporal Bone is typically not warranted because Temporal Bone metastases are usually a sign of widespread metastatic disease.
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Sarcomas of the Temporal Bone
Temporal Bone Cancer, 2018Co-Authors: Paul W. Gidley, Erich M. SturgisAbstract:Temporal Bone sarcomas represent a heterogeneous group of rare malignancies. Optimal treatment of Temporal Bone sarcoma is challenging and necessitates a multidisciplinary approach with surgery, chemotherapy, and radiotherapy. This chapter discusses the etiology, diagnosis, evaluation, staging, treatment, and prognosis of Temporal Bone sarcomas. It also introduces the most common types of Temporal Bone sarcoma.
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Unusual tumors of the Temporal Bone
Temporal Bone Cancer, 2018Co-Authors: Paul W. GidleyAbstract:This chapter discusses rare tumors of the Temporal Bone. While squamous cell carcinoma is the most common tumor to affect the Temporal Bone, other rare tumors are recognized. These tumor types include endolymphatic sac tumors, giant-cell tumor, and hemangiopericytoma. These tumors have unique characteristics and are individually discussed. Endolymphatic sac tumors and hemangiopericytomas are highly vascular tumors that often require preoperative embolization. Complete surgical excision is treatment of choice but is often difficult to achieve given the anatomy of the Temporal Bone. Radiotherapy offers reasonable local control in the postoperative setting when residual tumor remains.
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Temporal Bone Malignancies
Neurosurgery clinics of North America, 2013Co-Authors: Paul W. Gidley, Franco DemonteAbstract:Primary Temporal Bone tumors are rare. Suspicious lesions of the ear canal should be biopsied for diagnosis. Surgical resection to achieve negative margins is the mainstay of treatment. Small tumors can be treated with lateral Temporal Bone resection. Parotidectomy and neck dissection are added for disease extension and proper staging. Higher staged tumors generally require subtotal Temporal Bone resection or total Temporal Bone resection. Adjuvant postoperative radiotherapy has shown improved survival for some patients. Chemotherapy has an emerging role for advanced stage disease. Evaluation and management by a multidisciplinary team are the best approach for patients with these tumors.
Charles A. Lockwood - One of the best experts on this subject based on the ideXlab platform.
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Postnatal Temporal Bone ontogeny in Pan, Gorilla, and Homo, and the implications for Temporal Bone ontogeny in Australopithecus afarensis
American Journal of Physical Anthropology, 2013Co-Authors: Claire E Terhune, William H. Kimbel, Charles A. LockwoodAbstract:Assessments of Temporal Bone morphology have played an important role in taxonomic and phylogenetic evaluations of fossil taxa, and recent three-dimensional analyses of this region have supported the utility of the Temporal Bone for testing taxonomic and phylogenetic hypotheses. But while clinical analyses have examined aspects of Temporal Bone ontogeny in humans, the ontogeny of the Temporal Bone in non-human taxa is less well documented. This study examines ontogenetic allometry of the Temporal Bone in order to address several research questions related to the pattern and trajectory of Temporal Bone shape change during ontogeny in the African apes and humans. We further apply these data to a preliminary analysis of Temporal Bone ontogeny in Australopithecus afarensis. Three-dimensional landmarks were digitized on an ontogenetic series of specimens of Homo sapiens, Pan troglodytes, Pan paniscus, and Gorilla gorilla. Data were analyzed using geometric morphometric methods, and shape changes throughout ontogeny in relation to size were compared. Results of these analyses indicate that, despite broadly similar patterns, African apes and humans show marked differences in development of the mandibular fossa and tympanic portions of the Temporal Bone. These findings indicate divergent, rather than parallel, postnatal ontogenetic allometric trajectories for Temporal Bone shape in these taxa. The pattern of Temporal Bone shape change with size exhibited by A. afarensis showed some affinities to that of humans, but was most similar to extant African apes, particularly Gorilla. Am J Phys Anthropol 151:630–642, 2013. © 2013 Wiley Periodicals, Inc.
Derrick T Lin - One of the best experts on this subject based on the ideXlab platform.
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management outcomes following lateral Temporal Bone resection for ear and Temporal Bone malignancies
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Michael G Moore, Michael J. Mckenna, Daniel G Deschler, Mark A Varvares, Derrick T LinAbstract:ObjectiveTo evaluate clinical outcomes following lateral Temporal Bone resection (LTBR) for management of malignancies involving the ear or Temporal Bone.Subjects and MethodsA retrospective medical...
