ABSTRACT
OBJECTIVE: To assess the bone density around the bony labyrinth in otosclerosis patients and to compare it to that of a control population. MATERIAL AND METHODS: This was a prospective case-control study. Ten patients with otosclerosis (mean age 42 years; range 24-55 years) and 33 control patients with vestibular schwannoma (mean age 46 years; range 20-71 years) were included. All patients underwent a clinical examination, audiometry and a CT scan comprising axial and coronal views of both temporal bones. In the otosclerosis group, audiometry showed unilateral involvement in six patients and bilateral hearing loss in four. The bone density was measured at the fissula ante fenestram (FAF) and at five other anatomical points on the bony labyrinth. RESULTS: In the control group, the bone density was similar at the six anatomical points. In the otosclerosis patients, the mean bone density at the FAF was lower than that in control patients (1649+/-99.1 vs 2049+/-13.4 HU; p < 0.01). For patients with FAF bone densities < 2000 HU, a correlation was observed between hearing threshold and FAF bone density. CONCLUSION: FAF bone density appears to be a good indicator of disease progression, and could serve as a follow-up and prognostic parameter.
Subject(s)
Bone Density , Otosclerosis/diagnostic imaging , Temporal Bone/diagnostic imaging , Tomography, X-Ray Computed , Adult , Case-Control Studies , Female , Humans , Male , Middle Aged , Otosclerosis/pathology , Temporal Bone/pathologyABSTRACT
A 74-year-old male patient presented with increasing pain in the left preauricular region. On investigation he was diagnosed as having metastasis of a lung adenocarcinoma to the left parotid lymph node.
Subject(s)
Adenocarcinoma/secondary , Lung Neoplasms/diagnosis , Lymphatic Metastasis/diagnosis , Parotid Neoplasms/secondary , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Biopsy, Needle , Diagnosis, Differential , Humans , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Lymph Node Excision , Lymphatic Metastasis/pathology , Magnetic Resonance Imaging , Male , Parotid Gland/pathology , Parotid Gland/surgery , Parotid Neoplasms/diagnosis , Parotid Neoplasms/pathology , Parotid Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
A 49-year-old male developed left abducens nerve palsy as a result of metastatic spread of carcinoma of the cervical esophagus to Rouviere's node and infiltration of the petrous portion of the left temporal bone. Postmortem temporal bone histology revealed that cancer cells had invaded the greater superficial petrosal nerve (GPN), lesser superficial petrosal nerve, tensor tympani muscle (TTM) and the skin covering the anterior wall of the left external auditory meatus. These findings suggest that the carcinoma metastasized from the cervical esophagus to Rouviere's node and directly invaded the middle cranial fossa and then the temporal bone, and further infiltrated the middle ear via perineural invasion.
Subject(s)
Carcinoma, Squamous Cell/secondary , Esophageal Neoplasms/pathology , Head and Neck Neoplasms/pathology , Skull Neoplasms/secondary , Temporal Bone , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/diagnostic imaging , Head and Neck Neoplasms/diagnostic imaging , Humans , Male , Middle Aged , Neoplasm Invasiveness , Radiography , Skull Neoplasms/diagnostic imaging , Skull Neoplasms/pathology , Temporal Bone/pathologyABSTRACT
Two cases, a 41-year-old female and a 53-year-old female presenting with systemic lupus erythematosus and left vocal cord paralysis, are described in this paper. In both cases, laryngeal lupus and pulmonary hypertension were not detected. The laryngeal symptoms and signs were not improved by treatment with steroids, despite the systemic lupus erythematosus being under control.
