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The Incudomalleolar Articulation in Down Syndrome (Trisomy 21): a Temporal Bone Study
Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2015 The incudomalleolar articulation in down syndrome (trisomy 21): a temporal bone study Fausch, Christian ; Röösli, Christof Abstract: HYPOTHESIS: One reason for conductive hearing loss (HL) in patients with Down syndrome (DS) is structural anomalies in the incudomalleolar joint (IMJ) that impair sound transmission. BACK- GROUND: The majority of hearing losses in patients with DS are conductive. One reason is the high incidence of inflammatory processes such as otitis media. However, in some patients, the middle earseems to be normal. The assumption of structural disorders causing a HL is supported by a previous study revealing structural abnormalities of the incudostapedial joint (ISJ) in these patients. METHODS: In a retrospective analysis, histologic sections of the IMJ of 16 patients with DS were compared with 24 age- and sex-matched subjects with normal middle ear ossicles. The length of 8 parameters of the IMJ were measured at 3 positions and compared between the 2 groups. RESULTS: Age (p = 0.318) and sex distri- bution (p = 1) for the DS group and the matched controls were comparable. The IMJs (p < 0.001) and the cartilage of patients with DS are significantly wider in most measurements compared with controls. However, the joint space is not significantly different in the 2 groups. CONCLUSION: Conductive HL might be caused by a significantly wider IMJ in patients with DS supporting the findings of aprevious study reporting similar findings for the ISJ. The etiology of these findings is unclear. -
Redalyc.Deviant Facial Nerve Course in the Middle Ear Cavity
Brazilian Journal of Otorhinolaryngology ISSN: 1808-8694 [email protected] Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico- Facial Brasil Cho, Jungkyu; Choi, Nayeon; Hwa Hong, Sung; Moon, Il Joon Deviant facial nerve course in the middle ear cavity Brazilian Journal of Otorhinolaryngology, vol. 81, núm. 6, 2015, pp. 681-683 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial São Paulo, Brasil Available in: http://www.redalyc.org/articulo.oa?id=392442695018 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Document downloaded from http://bjorl.elsevier.es day 25/11/2015. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Braz J Otorhinolaryngol. 2015;81(6):681---683 Brazilian Journal of OTORHINOLARYNGOLOGY www.bjorl.org CASE REPORT ଝ Deviant facial nerve course in the middle ear cavity Trajeto anômalo do nervo facial na cavidade da orelha média ∗ Jungkyu Cho, Nayeon Choi, Sung Hwa Hong, Il Joon Moon Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Received 27 December 2014; accepted 17 March 2015 Available online 7 September 2015 Introduction (Fig. 1A). Other physical exams showed no facial nerve palsy or auricular anomaly (Fig. 1B). Pure-tone average Anomalous facial nerve (FN) course can be found in a sig- (0.5, 1, 2, and 3 kHz) showed air-bone gap of 58 dB nificant number of cases with aural anomalies. -
The Myloglossus in a Human Cadaver Study: Common Or Uncommon Anatomical Structure? B
Folia Morphol. Vol. 76, No. 1, pp. 74–81 DOI: 10.5603/FM.a2016.0044 O R I G I N A L A R T I C L E Copyright © 2017 Via Medica ISSN 0015–5659 www.fm.viamedica.pl The myloglossus in a human cadaver study: common or uncommon anatomical structure? B. Buffoli*, M. Ferrari*, F. Belotti, D. Lancini, M.A. Cocchi, M. Labanca, M. Tschabitscher, R. Rezzani, L.F. Rodella Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy [Received: 1 June 2016; Accepted: 18 July 2016] Background: Additional extrinsic muscles of the tongue are reported in literature and one of them is the myloglossus muscle (MGM). Since MGM is nowadays considered as anatomical variant, the aim of this study is to clarify some open questions by evaluating and describing the myloglossal anatomy (including both MGM and its ligamentous counterpart) during human cadaver dissections. Materials and methods: Twenty-one regions (including masticator space, sublin- gual space and adjacent areas) were dissected and the presence and appearance of myloglossus were considered, together with its proximal and distal insertions, vascularisation and innervation. Results: The myloglossus was present in 61.9% of cases with muscular, ligamen- tous or mixed appearance and either bony or muscular insertion. Facial artery pro- vided myloglossal vascularisation in the 84.62% and lingual artery in the 15.38%; innervation was granted by the trigeminal system (buccal nerve and mylohyoid nerve), sometimes (46.15%) with hypoglossal component. Conclusions: These data suggest us to not consider myloglossus as a rare ana- tomical variant. -
Doctoral Dissertation Template
UNIVERSITY OF OKLAHOMA GRADUATE COLLEGE MECHANICAL PROPERTIES OF HUMAN INCUDOSTAPEDIAL JOINT AND TYMPANIC MEMBRANE IN NORMAL AND BLAST-DAMAGED EARS A DISSERTATION SUBMITTED TO THE GRADUATE FACULTY in partial fulfillment of the requirements for the Degree of DOCTOR OF PHILOSOPHY By SHANGYUAN JIANG Norman, Oklahoma 2018 MECHANICAL PROPERTIES OF HUMAN INCUDOSTAPEDIAL JOINT AND TYMPANIC MEMBRANE IN NORMAL AND BLAST-DAMAGED EARS A DISSERTATION APPROVED FOR THE STEPHENSON SCHOOL OF BIOMEDICAL ENGINEERING BY ______________________________ Dr. Rong Z. Gan, Chair ______________________________ Dr. Vassilios I. Sikavitsas ______________________________ Dr. Matthias U. Nollert ______________________________ Dr. Edgar A. O’Rear ______________________________ Dr. Harold L. Stalford © Copyright by SHANGYUAN JIANG 2018 All Rights Reserved. I dedicate my dissertation work to my family. Acknowledgements I would like to express my sincere appreciation to my advisor, Dr. Rong Z. Gan for the enormous amount time, energy, resource, and patience she had devoted in my training process. I joined the Ph.D. program at the University of Oklahoma right after I got my bachelor degree and with great language difficulties. Dr. Gan has been teaching me how to think, read, learn and write as a researcher regardless of my weak background since the first day I arrived in the US. Her respect, enthusiasm, and persistence to work has deeply impressed me and changed my attitude towards my work and life. The past five years in the biomedical engineering laboratory is one of the most precious experiences in my life. I would like to express my appreciation to my committee members, Dr. Vassilios I. Sikavitsas, Dr. Matthias U. Nollert, Dr. Edgar A. -
Case Report and Osteopathic Treatment
Journal name: International Medical Case Reports Journal Article Designation: Case Report Year: 2016 Volume: 9 International Medical Case Reports Journal Dovepress Running head verso: Bordoni et al Running head recto: The tongue after whiplash open access to scientific and medical research DOI: http://dx.doi.org/10.2147/IMCRJ.S111147 Open Access Full Text Article CASE REPORT The tongue after whiplash: case report and osteopathic treatment Bruno Bordoni1–3 Abstract: The tongue plays a fundamental role in several bodily functions; in the case of a Fabiola Marelli2,3 dysfunction, an exhaustive knowledge of manual techniques to treat the tongue is useful in Bruno Morabito2–4 order to help patients on their path toward recovery. A 30-year-old male patient with a recent history of whiplash, with increasing cervical pain during swallowing and reduced ability to open 1Department of Cardiology, Santa Maria Nascente IRCCS, the mouth, was treated with osteopathic techniques addressed to the tongue. The osteopathic Don Carlo Gnocchi Foundation, techniques led to a disappearance of pain and the complete recovery of the normal functions of Institute of Hospitalization and the tongue, such as swallowing and mouth opening. The manual osteopathic approach consists Care with Scientific Address, Milan, 2CRESO, School of Osteopathic of applying a low load, in order to produce a long-lasting stretching of the myofascial complex, Centre for Research and Studies, with the aim of restoring the optimal length of this continuum, decreasing pain, and improving Castellanza,3CRESO, School of functionality. According to the authors’ knowledge, this is the first article reporting a case of Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, resolution of a post whiplash disorder through osteopathic treatment of the tongue. -
Treatment of a Traumatic Incudomalleolar Joint Subluxation with Hydroxyapatite Bone Cement Dennis Bojrab II 1, Jennifer F Ha2,3,4,5*, David a Zopf 1
Annals of International Case Report Case Report Open Access | Research Treatment of A Traumatic Incudomalleolar Joint Subluxation with Hydroxyapatite Bone Cement Dennis Bojrab II 1, Jennifer F Ha2,3,4,5*, David A Zopf 1 1Department of Paediatrics Otolaryngology Head & Neck Surgery, University of Michigan Health System, C.S. Mott Children’s Hospital, 1540 East Hospital Drive, Ann Arbor, Michigan 48109, United States of America 2Department of Paediatrics Otolaryngology Head & Neck Surgery, Perth Children’s Hospital, Roberts Road, Nedlands 6009, Western Australia 3Murdoch ENT, Wexford Medical Centre, St John of God Hospital (Murdoch), Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch 6150, West- ern Australia 4School of Surgery, University of Western Australia, Stirling Highway, Crawley 6009, Western Australia 5 St John of God Hospital (Murdoch), Wexford Medical Centre, Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch 6150, Western Australia Abstract Trauma-related hearing loss can be conductive, sensorineural, or mixed in nature. Alteration of any of the conductive mechanisms can result in a conductive hearing loss. Depending on the location and type of ossicular injury there several reconstructive options have been described. Hydroxyapetite cement has been reported on several occasions for incudostapedial dislocation, however, rare- ly/never for incudomalleolar dislocation. Here we report a patient with traumatic Incudomalleolar Joint (IMJ) separation which was successfully repaired using bone cement. Case Description A 15-year-old male patient was referred to our Paediatric Otolaryngology department by his paediatrician with a lifelong history of left sided hearing loss. He was involved in two motor vehicle accidents when he was younger. -
Appendix B: Muscles of the Speech Production Mechanism
Appendix B: Muscles of the Speech Production Mechanism I. MUSCLES OF RESPIRATION A. MUSCLES OF INHALATION (muscles that enlarge the thoracic cavity) 1. Diaphragm Attachments: The diaphragm originates in a number of places: the lower tip of the sternum; the first 3 or 4 lumbar vertebrae and the lower borders and inner surfaces of the cartilages of ribs 7 - 12. All fibers insert into a central tendon (aponeurosis of the diaphragm). Function: Contraction of the diaphragm draws the central tendon down and forward, which enlarges the thoracic cavity vertically. It can also elevate to some extent the lower ribs. The diaphragm separates the thoracic and the abdominal cavities. 2. External Intercostals Attachments: The external intercostals run from the lip on the lower border of each rib inferiorly and medially to the upper border of the rib immediately below. Function: These muscles may have several functions. They serve to strengthen the thoracic wall so that it doesn't bulge between the ribs. They provide a checking action to counteract relaxation pressure. Because of the direction of attachment of their fibers, the external intercostals can raise the thoracic cage for inhalation. 3. Pectoralis Major Attachments: This muscle attaches on the anterior surface of the medial half of the clavicle, the sternum and costal cartilages 1-6 or 7. All fibers come together and insert at the greater tubercle of the humerus. Function: Pectoralis major is primarily an abductor of the arm. It can, however, serve as a supplemental (or compensatory) muscle of inhalation, raising the rib cage and sternum. (In other words, breathing by raising and lowering the arms!) It is mentioned here chiefly because it is encountered in the dissection. -
Imaging of Temporal Bone Trauma
Imaging of Temporal Bone Trauma Tabassum A. Kennedy, MD*, Gregory D. Avey, MD, Lindell R. Gentry, MD KEYWORDS Temporal bone fracture Trauma Ossicular injury Hearing loss Facial nerve Cerebrospinal fluid leak Pneumolabyrinth Perilymphatic fistula KEY POINTS Multidetector temporal bone computed tomography examinations should be performed in patients with a clinical or radiographic suspicion of temporal bone fracture. Categorization of temporal bone fractures should include a descriptor for fracture direction, the presence or absence of labyrinthine involvement, and the segment of temporal bone involved. It is important to identify associated complications related to temporal bone trauma that will guide management. Complications include injury to the tympanic membrane, ossicular chain, vestibulo- cochlear apparatus, facial nerve, tegmen, carotid canal, and venous system. INTRODUCTION evaluation with a noncontrast CT examination of the head. Careful scrutiny of the temporal bone The temporal bone is at risk for injury in the setting on head CT is necessary to detect primary and of high-impact craniofacial trauma occurring in 3% secondary signs of temporal bone injury. External to 22% of patients with trauma with skull fractures 1–3 auditory canal opacification, otomastoid opacifi- (Table 1). Motor vehicle collisions, assaults, cation, air within the temporomandibular joint, and falls are the most common mechanisms of 4–6 ectopic intracranial air adjacent to the temporal injury. Most patients with temporal bone trauma bone, and pneumolabyrinth in the setting of sustain unilateral injury, occurring in 80% to 90% 5,7,8 trauma should raise the suspicion of an associated of cases. Multidetector computed tomography temporal bone fracture (Fig. 1). Patients with (CT) has revolutionized the ability to evaluate the temporal bone trauma often sustain concomitant intricate anatomy of the temporal bone, enabling intracranial injury, which often necessitates more clinicians to detect fractures and complications emergent management. -
Necrosis of the Long Process of the Incus Following Stapes Surgery: New Anatomical Observations
The Laryngoscope VC 2009 The American Laryngological, Rhinological and Otological Society, Inc. Necrosis of the Long Process of the Incus Following Stapes Surgery: New Anatomical Observations Imre Gerlinger, MD, PhD; Miklo´sTo´th, MD, PhD; La´szlo´ Lujber, MD, PhD; Istva´n Szanyi, MD; Pe´ter Mo´ricz, MD; Krisztina Somogyva´ri, MD; Adrienn Ne´meth, MD; Ga´bor Ra´th, MD; Jo´zsef Pytel, MD, PhD; Wolfgang Mann, MD, PhD, FACS Objectives/Hypothesis: The most frequent incudes revealed 1-4 nutritive foramina on the long complication (generally recognized during revision processes of 48% (24) of the left-sided incudes and procedures) following seemingly successful stapedoto- 56% (28) of the right-sided incudes. The positions of mies and stapedectomies is necrosis of the long pro- these foramina differed, however, from those previ- cess of the incus. This is currently ascribed to a mal- ously described in the literature. They were mostly crimped stapes prosthesis or to a compromised blood located not on the medial side of the incus body or on supply of the incus. The two-point fixation can cause the short process or on the cranial third of the long a mucosal injury with a resulting toxic reaction, and processes, but antero-medially, mostly on the middle also osteoclastic activity. An important aspect in the or cranial third. In 48% of all the incudes examined, engineering of ideal stapes prostheses is that they an obvious foramen was not observed either in the should be fixed circularly to the long process of the body or in the long process of the incus. -
Ossiculoplasty for Malleus Bar with Incudostapedial Disconnection and Fused Incudomalleolar Joint
Hindawi Case Reports in Otolaryngology Volume 2020, Article ID 8828969, 4 pages https://doi.org/10.1155/2020/8828969 Case Report Ossiculoplasty for Malleus Bar with Incudostapedial Disconnection and Fused Incudomalleolar Joint Yuji Kanazawa , Hitomi Matsuura, Natsumi Aiso, and Masako Nakai Department of Otolaryngology, Shiga Medical Center for Children, 5-7-30 Moriyama, Moriyama City 524-0022, Japan Correspondence should be addressed to Yuji Kanazawa; [email protected] Received 3 April 2020; Revised 22 June 2020; Accepted 4 July 2020; Published 23 July 2020 Academic Editor: Nicola´s Pe´rez Ferna´ndez Copyright © 2020 Yuji Kanazawa et al. .is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Malleus bar is an abnormal bony connection between the malleus handle and the posterior wall of the tympanic cavity. We report a patient with a malleus bar and another malformation of the ossicles. An 11-year-old boy presented with hearing impairment since early childhood. Computed tomography (CT) revealed a malleus bar with an incudostapedial disconnection in the right ear. At tympanoplasty, the malleus bar was first identified and removed. A fused malleus-incus, not visible on the preoperative CT, was found intraoperatively. .erefore, the fused malleus-incus was removed; then, the ossicular chain was reconstructed, resulting in an improved postoperative hearing level. On preoperative CT, the disconnected incudostapedial joint had been identified, whereas the fused malleus-incus had not. Given the variations in the malleus bar anomaly of the middle ear, the surgical procedure for ossiculoplasty should be adapted intraoperatively based on any findings not visible on the preoperative CT. -
42 CONDUCTIVE DEAFNESS FOLLOWING HEAD INJURY: REPAIR of a DISLOCATED INCUDOSTAPEDIAL JOINT by WIRING* 0,1% Energy Penetrates
.,------------------_..._"''"'-.._.-----~----------------------------- 42 S.A. TYDSKRIF VIR GENEESKUNDE 11 Januarie 1969 CONDUCTIVE DEAFNESS FOLLOWING HEAD INJURY: REPAIR OF A DISLOCATED INCUDOSTAPEDIAL JOINT BY WIRING* ERICH KUSCHKE, M.B., CH.B. (PRET.), D. MID. C.O. & G. (S.A.), M.Mw. (OTOL.) (CAPE TOWN), Department of Otolaryngology, University of Cape Town and Groote Schuur Hospital The mechanism and nature of injury to the ossicular of 1 G under experimental conditions. Transposed to man, chain have been studied and understood only comparatively this would represent a substantial force and would be recently. With the operating microscope it has become directed against the smallest, the finest and most delicate possible to verify a diagnosis of disruption of the ossicu joint of the human body. lar chain and to treat the condition. The diagnosis is more Does and Bottema' state that during the trauma the frequently made because of (a) increased awareness of the skull, including the middle ear, is most likely distorted in entity by otologists and neurosurgeons, and (b) the in such a way as to displace the incus. crease in traffic accidents. It is of obvious medico-Iegal importance. DIAGNOSIS History ANATOMY AND MECHANISM Severe cranial trauma, often with bleeding from the ear, Congenital interruption of the chain occurs, but is rare. is foHowed by persistent conductive deafness. Conductive This is rather surprising when one considers that the deafness due to haemotympanum or a tear of the tympanic malleus and incus develop from the first visceral arch membrane is temporary, unless infection supervenes. The and the stapes and stapedius muscle from the second arch. -
MASTOIDECTOMY & EPITYMPANECTOMY Tashneem Harris & Thomas Linder
OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY MASTOIDECTOMY & EPITYMPANECTOMY Tashneem Harris & Thomas Linder Chronic otitis media, with or without cho- to describe the different types of mastoid- lesteatoma, is one of the more common ectomy as summarized in Table 1. indications for performing a mastoidecto- my. Mastoidectomy permits access to re- Table 1: Types of mastoidectomy move cholesteatoma matrix or diseased air cells in chronic otitis media. Mastoidec- Canal wall up Canal wall down tomy is one of the key steps in placing a mastoidectomy mastoidectomy cochlear implant. Here a mastoidectomy Combined approach Radical mastoidectomy allows the surgeon access to the middle ear Intact canal wall Modified radical through the facial recess. A complete mastoidectomy mastoidectomy mastoidectomy is not necessary; therefore, Closed technique Open technique the term anterior mastoidectomy is often Front-to-back mastoidectomy used (anterior to the sigmoid sinus). A Atticoantrostomy mastoidectomy is often an initial step in Open mastoidoepitympanec- lateral skull base surgery for tumours tomy involving the lateral skull base, including vestibular schwannomas, meningiomas, One of the problems is that the termino- temporal bone paragangliomas (glomus logy does not in fact entail specific infor- tumours), and epidermoids or repair of mation about what was done either to the CSF leaks arising from the temporal bone. middle ear or the mastoid. It is the authors’ preference to use the terms open/closed Definition of Cholesteatoma mastoidoepitympanectomy and to state separately whether a tympanoplasty or Cholesteatoma is a chronic middle ear in- ossiculoplasty was done e.g. left open fection with squamous epithelium and mastoidoepitympanectomy and tympano- retention of keratin in the middle ear and/ plasty type III.