- MeSH
- barotrauma diagnóza etiologie patologie MeSH
- dítě MeSH
- fraktury kostí diagnostické zobrazování klasifikace MeSH
- lidé MeSH
- spánková kost zranění MeSH
- úrazy a nehody * MeSH
- vertigo diagnostické zobrazování klasifikace MeSH
- vestibulární nemoci * diagnostické zobrazování klasifikace patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
Prezentujeme případ 42leté ženy s potvrzeným zděděným syndromem von Hippel-Lindau (VHL) a s recidivujícím tumorem endolymfatického vaku (ELST) vlevo, který se prezentoval jako nehomogenní, solidně – cystická expanze pyramidy vlevo. Histologicky byly zastiženy lamely kosti s přilehlým vazivem a s přítomností léze papilárního vzhledu tvořenou centrálně vazivovou a cévnatou tkání, na jejíž papily nasedají poměrně drobné kubické elementy s lehce nepravidelnými hyperchromními jádry. Ojediněle byly zastiženy i drobné cystické formace s obsahem PAS pozitivního eozinofilního materiálu. Imunohistochemicky vykazovaly kubické elementy difuzní expresi vimentinu, epiteliálního membránového antigenu (EMA), cytokeratinu AE1/AE3 a S100 proteinu (pouze slabě). Další vyšetřované markery zahrnující TTF1, PAX8 a CD10 byly negativní. Tumor endolymfatického vaku je vzácný low-grade maligní epiteliální tumor vycházející z endolymfatického vaku v temporální kosti, s incidencí 1:30 000, s popsanými méně než 300 případy. Asi 1/3 z nich je asociována s VHL, autozomálně dominantním familiárním nádorovým syndromem.
We report the case of a 42-year – old female with familiar form von Hippel-Lindau disease (VHL) and recurrent endolymphatic sac tumour (ELST), which was presented like non-homogenous, solid and cystic expansion of the left petrous temporal bone. Histologically, there was found lamellae of bone with adjacent ligament and with papillary projections with fibrovascular core. The papillae were lined by a single layer of cuboidal epithelium with hyperchromatic and lightly pleomorphic nuclei. Sporadically, small cystic formations with eosinophilic, PAS positive secretion were noted. Imunohistochemically, the cuboidal cells showed diffuse positivity for vimentin, epithelial membrane antigen (EMA), cytokeratin AE1/AE3 and S100 protein (weakly). Other markers examined, including TTF1, PAX8 and CD10, were negative. Endolymphatic sac tumour is rare low-grade malignant epithelial tumour arising from the endolymphatic sac in the temporal bone, which occurs in 1 out of 30 000 births, with just fewer than 300 cases reported in the literature. About one third of cases are associated with von Hippel- Lindau disease, an autosomal dominant familial cancer syndrome.
- MeSH
- adenom patologie MeSH
- dědičné nádorové syndromy komplikace patologie MeSH
- imunohistochemie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory kostí komplikace MeSH
- nádory ucha chirurgie patologie MeSH
- saccus endolymphaticus * chirurgie patologie MeSH
- spánková kost patologie MeSH
- von Hippelova-Lindauova nemoc komplikace patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Background: Eagle’s syndrome (ES) is a term describing a group of symptoms associated with the elongation of the styloid process (SP) of the temporal bone or with ossification of the stylohyoid ligament. Clinically, it manifests through pain in the orofacial and pharyngeal regions, similar to that experienced by patients with temporomandibular joint disease. The presented paper aims to assess the evaluation of the success of surgical treatment and the complications associated with such treatment. Methods: Our retrospective study includes nine patients with ES treated in our Department Oral and Maxillofacial Surgery in years 2019–2023 (median age of 47 years) – all patients affected with this disease out of 2,716 patients examined at our department due to a temporomandibular joint disease. Eight of these patients underwent a surgical resection of the SP. The success and complications in these patients are evaluated in this study. Results: In seven patients, the problems disappeared or at least diminished, which is consistent with data from the literature. Postoperative complications such as deficit of the marginal branch of the facial nerve (n. VII), limited sticking the tongue out (n. XII), and velopharyngeal insufficiency (n. IX) occurred in three patients. Conclusion: The wide spectrum of clinical manifestations makes ES a condition that should be considered in the differential diagnosis of temporomandibular joint disorders, post-traumatic conditions, or complicated eruption of wisdom teeth or their extraction. ES can be treated conservatively or (mostly) surgically. Surgical treatment can be relatively successful and effective, but it is necessary to respect the anatomical placement of the SP, which can be associated with the development of complications, especially in cases with extremely long SP.
Autori prezentujú kazuistiku 38-ročnej pacientky, ktorá prichádza na kliniku otorinolaryngológie a chirurgie hlavy a krku v Ružomberku pre 18 mesiacov trvajúce vertigo, pravostranný tinitus, percepčnú poruchu sluchu a parézu tvárového nervu. Bol diagnostikovaný tumor spánkovej kosti o veľkosti 8 mm lokalizovaný v oblasti laterálneho, zadného polkruhovitého kanálika a vestibula, ktorý bol peroperačne identifikovaný ako extrémne vzácny low-grade agresívny adenokarcinóm saccus endolymphaticus. V kazuistike autori rozoberajú anatómiu, diagnostiku, CT a MR snímky, zvolený operačný postup, následnú dispenzarizáciu pacientky a prehľad príslušnej literatúry.
The authors present a case report of a 38-year-old female patient admitted at the Department of Otorhinolaryngology and Head and Neck Surgery in Ružomberok with an 18-month history of vertigo, right-sided tinnitus, sensorineural hearing loss and facial nerve paresis. The patient was diagnosed with an 8 mm temporal bone tumor, located in the area of the lateral posterior semicircular canal and vestibule, which was intraoperatively identified as an extremely rare aggressive low-grade adenocarcinoma of the endolymphatic sac. In the case report, the authors discuss the anatomy, diagnosis, CT and MRI images, the chosen surgical procedure and the subsequent dispensarization of the patient as well as an overview of the relevant literature.
- MeSH
- dospělí MeSH
- lidé MeSH
- papilární adenokarcinom * chirurgie diagnóza MeSH
- saccus endolymphaticus chirurgie patologie MeSH
- spánková kost chirurgie patologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
HYPOTHESIS: Higher light intensity settings do not yield improved image quality in endoscopic ear surgery. BACKGROUND: Light intensity is a parameter with major impact on the quality of digital images. For ear surgery, light produces heat associated with a thermal risk to ear structures and the light source setting should be accordingly optimized. METHODS: Several series of still images were acquired during live middle ear surgery, using cadaveric and plastic temporal bone models and with three-dimensional printed models. Images obtained under varying light intensities were compared with the image acquired at maximum intensity of a light emitting diode light source. We analyzed digital image brightness and noise using quantitative methods. RESULTS: Our measurements revealed significantly decreased image brightness with light intensities set below 20% with an increase in noise at light intensities lower than 30%. CONCLUSION: The optimal light source setting corresponded to 30% intensity in our experimental set-up. Special attention should be given to those cases where faster image quality degradation is expected (dark or bloody scenes or larger cavities). The results were strongly dependent on the equipment used. The methods described in this study can serve as a general guide for determining the optimal light source setting in any specific set-up.
- MeSH
- endoskopie MeSH
- lidé MeSH
- otologické chirurgické výkony * MeSH
- spánková kost MeSH
- střední ucho chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Temporal bone chondroblastoma is a rare, locally aggressive tumour originating from immature cartilage, which recurs to a high degree. Treatment is surgical. Radiotherapy is reserved for recurrence. We describe a case of a 15-year-old-boy choosing a conservative surgical approach with reconstruction of the posterior canal wall. This study aims to report a rare pediatric case. METHODS: A literature review was performed to better understand temporal bone chondroblastomas, to describe their histopathological and radiological characteristics and to establish the optimal surgical and non-surgical treatments. The research of previous published data was done using PubMed with keywords mentioned below. RESULTS: Authors present a case of a 15-year-old boy with hearing impairment and facial nerve palsy. Conservative surgery with reconstruction of the tympanic membrane and posterior wall of the external auditory canal, restoring the hearing has been performed. We did not administer any adjuvant therapies. No sign of recurrence was observed 1 year after primary surgery. Facial nerve function is normal, and hearing is satisfactory. CONCLUSION: Chondroblastomas account for less than 1% of primary bone tumours. Temporal bone chondroblastoma is rare, locally aggressive, with a high prevalence of recurrence. This study describes specific histopathological and radiological findings, the chosen surgical approach and follow-up to improve the management and the prognosis of patients affected with this particular clinical entity.
- MeSH
- chondroblastom * diagnostické zobrazování chirurgie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladiství MeSH
- nádory kostí * diagnostické zobrazování chirurgie MeSH
- rentgendiagnostika MeSH
- spánková kost diagnostické zobrazování chirurgie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Skeletal developmental anomalies (SDA) are a subject of constant interest across scientific disciplines, but still mostly as isolates and curiosities. The aim of this study was to find out to what extent the occurrence of SDA reflects documented biological relationships. The skeletal remains of 34 individuals with known genealogical data were available, members of one family over four generations (19th to 20th centuries, Bohemia, Czech Republic), including some inbred individuals. The occurrence of 89 SDA was assessed on the basis of scopic morphological evaluation and X-ray and CT examinations. The degree of similarity between individuals was calculated using a "similarity coefficient" (SC). A linear model was used to test the relationship between positive values of the SC and the relatedness of biologically related individuals. Simultaneously, based on population frequencies of the evaluated anomalies, those that could be considered familial were recorded. A statistically significant relationship between morphological similarity and the biological distance between individuals was found. The greatest similarity was found among close relatives such as parents and children, siblings, or grandparents and grandchildren. The effect of increased consanguinity on the occurrence of anomalies was not confirmed, however. Seventeen SDA shared by closely related individuals were found in the sample, supporting the documented family relationships among them. Eleven of these were selected as possibly familial, but only five were statistically significant: an elongated styloid process, a cervical block vertebrae (arch, facet joints), hamate hamulus aplasia, anteater nose sign, and incomplete fusion of the S1 spinous process. There were also 28 cases of individual occurrences of 17 different SDA, without connection to the documented relationships between individuals.
- MeSH
- dítě MeSH
- krční obratle * MeSH
- krk MeSH
- lidé MeSH
- spánková kost MeSH
- tělesné pozůstatky * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: Temporal bone meningioma is an extremely rare disease. Lack of clinical attention due to its rarity might lead to delayed diagnosis. This short communication aims to emphasize radiologic signs of temporal bone meningiomas to improve preoperative diagnosis. METHODS: Radiological characteristics of temporal bone meningiomas are discussed. RESULTS: Temporal bone meningioma is characterized by diffuse "hairy" trabecular hyperostosis without the destruction of trabecular structures, bone thickening, and irregular surface margins of the temporal bone on computed tomography. The dural tail sign is a unique feature of temporal bone meningioma on magnetic resonance imaging. CONCLUSION: Otolaryngologists certainly should be aware of characteristic radiologic signs of temporal bone meningiomas. Using modern computed tomography and magnetic resonance imaging protocols enables with a high degree of accuracy to distinguish temporal bone meningiomas from other more common entities in this location.
- MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- meningeální nádory * diagnostické zobrazování chirurgie MeSH
- meningeom * diagnostické zobrazování chirurgie MeSH
- počítačová rentgenová tomografie MeSH
- spánková kost diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Cílem kazuistiky je upozornit na velmi vzácnou patologii – meningeom spánkové kosti. Extrakraniální výskyt meningeomů je ojedinělý a v případě menigeomu spánkové kosti vzácný. Meningeomy spánkové kosti se projevují nespecificky známkami chronického středoušního zánětu s cholesteatomem. Při vyšetření počítačovou tomografií je typická změna architektoniky spánkové kosti bez destrukce kosti, kterou by měl otorinolaryngolog a radiolog znát a při podezření na meningeom indikovat magnetickou rezonanci. Volba léčebné strategie závisí na mnoha faktorech, nejčastější léčbou je kombinace neurochirurgického a kofochirurgického operačního výkonu. Alternativou může být stereotaktické ozáření.
The aim of this case report is to discuss a very rare pathology – temporal bone meningioma. The extracranial location of meningiomas and temporal bone meningioma is a very rare condition. The symptomatology of temporal bone meningiomas is nonspecific, imitating chronic otitis media with cholesteatoma. However, temporal bone meningioma has a distinctive image on computed tomography. There is a change in the architecture without bone destruction that should be known by otorhinolaryngologist and radiologist. Magnetic resonance paging should be performed when temporal bone meningioma is suspected. The management of temporal bone meningiomas depends on a variety of factors. The most common therapy includes a combination of neurosurgical and otological surgery. There are also alternatives like stereotactic irradiation.
- MeSH
- dospělí MeSH
- lidé MeSH
- meningeom * chirurgie diagnostické zobrazování radioterapie MeSH
- otitis media etiologie MeSH
- radiochirurgie metody MeSH
- spánková kost patologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
OBJECTIVE: The extreme lateral supracerebellar infratentorial (ELSI) approach has the potential to access several distinct anatomical regions that are otherwise difficult to reach. We have illustrated the surgical anatomy through cadaveric dissections and provided an extensive review of the literature to highlight the versatility of this approach, its limits, and comparisons with alternative approaches. METHODS: The surgical anatomy of the ELSI has been described using 1 adult-injected cadaveric head. Formalized noninjected brain specimens were also dissected to describe the brain parenchymal anatomy of the region. An extensive review of the literature was performed according to each targeted anatomical region. Illustrative cases are also presented. RESULTS: The ELSI approach allows for wide exposure of the middle and posterolateral incisural spaces with direct access to centrally located intra-axial structures such as the splenium, pulvinar, brainstem, and mesial temporal lobe. In addition, for skull base extra-axial tumors such as petroclival meningiomas, the ELSI approach represents a rapid and adequate method of access without the use of extensive skull base approaches. CONCLUSIONS: The ELSI approach represents one of the most versatile approaches with respect to its ability to address several anatomical regions centered at the posterior and middle incisural spaces. For intra-axial pathologies, the approach allows for access to the central core of the brain with several advantages compared with alternate approaches that frequently involve significant brain retraction and cortical incisions. In specific cases of skull base lesions, the ELSI approach is an elegant alternative to traditionally used skull base approaches, thereby avoiding approach-related morbidity.
- MeSH
- disekce MeSH
- dura mater anatomie a histologie MeSH
- hluboké zádové svaly anatomie a histologie chirurgie MeSH
- lidé MeSH
- mozeček anatomie a histologie MeSH
- mozkový kmen anatomie a histologie chirurgie MeSH
- mrtvola MeSH
- neurochirurgické výkony metody MeSH
- pulvinar anatomie a histologie chirurgie MeSH
- skalní kost anatomie a histologie chirurgie MeSH
- spánkový lalok anatomie a histologie chirurgie MeSH
- thalamus anatomie a histologie chirurgie MeSH
- zadní jáma lební anatomie a histologie chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
