Extradural pneumatocele after temporal craniotomy: case report.
(50/118)
A 22-year-old female first presented with a fibrillary astrocytoma in the left temporal region manifesting as complex partial seizure. She underwent left temporal craniotomy to remove the tumor. Surgery was uneventful, but she began to experience a blocked feeling in the left ear after surgery. Computed tomography (CT) obtained 3 weeks after surgery revealed persistent extradural air collection, which developed into an enlarged extradural air mass on follow-up CT obtained 8 months after surgery. She underwent additional surgery for obliteration of the pneumatocele by sealing the mastoidal fenestration with abdominal fat. She reported resolution of the symptom postoperatively. Extradural pneumatocele following temporal craniotomy is extremely rare, but is a possible surgical complication of opening of the mastoid sinuses. (+info)
A primary large cholesterol cyst of the mastoid presenting with dysgeusia.
(51/118)
The occurrence of postoperative secondary cholesterol cysts in the mastoid has been previously reported, however the occurrence of a primary large cholesterol cyst in the mastoid with bony destruction of the facial nerve has rarely been reported. The case report of a 17-year-old female patient with a primary large cholesterol cyst with dysgeusia is presented. Computed tomography and magnetic resonance imaging findings for the lesion distinguish a cholesterol granuloma, cholesteatoma and vascular tumor. The patient underwent a canal wall down mastoidectomy with mastoid obliteration. A dehiscent portion of the mastoid segment of the facial nerve was visible within the cavity; the gross finding of the facial nerve was edematous in appearance. Five years later, there has been no recurrence of disease. (+info)
Huge cholesterol granuloma of the middle ear extending to middle cranial fossa.
(52/118)
Cholesterol granuloma (CG) may erode into the middle ear, the mastoid bone and the petrous apex. However, aggressive erosion into the cranial cavity is extremely rare. Here we report a case of huge CG extending to the middle cranial fossa. Temporal bone computerized tomography showed a soft tissue mass which destroyed the bony plate of the posterior and middle cranial fossa. On magnetic resonance imaging, the mass revealed a high signal on both T1 and T2-weighted images. The mass compressed the middle cranial fossa without invasion into the brain. The CG was removed by extended cortical mastoidectomy. The postoperative course was uneventful and there were no neurological complications. (+info)
Mastoid cavity dimensions and shape: method of measurement and virtual fitting of implantable devices.
(53/118)
MRI, not CT, to rule out recurrent cholesteatoma and avoid unnecessary second-look mastoidectomy.
(54/118)
BACKGROUND: Aural cholesteatoma is an epidermal cyst of the middle ear or mastoid that can be eradicated only by surgical resection. It is usually managed with radical or modified radical mastoidectomy. Clinical diagnosis of recurrent cholesteatoma in a closed postoperative cavity is difficult. Thus, the accepted protocol in most otologic centers for suspected recurrence consists of second-look procedures performed approximately 1 year after the initial surgery. Brain herniation into a post-mastoidectomy cavity is not rare and can be radiologically confused with cholesteatoma on the high resolution computed tomographic images of temporal bones that are carried out before second-look surgery. OBJECTIVES: To present our experience with meningoceles that were confused with recurrent disease in patients who had undergone primary mastoidectomy for cholesteatoma and to support the use of magnetic resonance imaging as more suitable than CT in postoperative follow-up protocols for cholesteatoma. METHODS: We conducted a retrospective chart review of four patients. RESULTS: Axial CT sections demonstrated a soft tissue mass in the middle ear and mastoid in all four patients. Coronal reconstructions of CT scans showed a tympanic tegmen defect in two patients. CT failed to exclude cholesteatoma in any patient. Each underwent a second-look mastoidectomy and the only finding at surgery was meningocele in all four patients. CONCLUSIONS: Echo-planar diffusion-weighted MRI can differentiate between brain tissue and cholesteatoma more accurately than CT. We recommend that otolaryngologists avoid unnecessary revision procedures by using the newest imaging modalities for more precise diagnosis of patients who had undergone mastoidectomy for cholesteatoma in the past. (+info)
Enhancing realism of wet surfaces in temporal bone surgical simulation.
(55/118)