Temporal Bone Lesions - utmb.edu
-
Upload
nguyenduong -
Category
Documents
-
view
255 -
download
4
Transcript of Temporal Bone Lesions - utmb.edu
![Page 1: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/1.jpg)
Temporal Bone Lesions Alan L. Cowan, MD
Faculty Advisor: Matthew W. Ryan, MD
The University of Texas Medical Branch
Department of Otolaryngology
Grand Rounds Presentation
September 15, 2004
![Page 2: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/2.jpg)
Division of Lesions
External Auditory Canal
Middle Ear and Mastoid
Labyrinth
Internal Auditory Canal & CPA
Petrous Apex
Ubiquitous Lesions
![Page 3: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/3.jpg)
External Auditory Canal
Benign Tumors
Exostosis
Osteoma
Malignant Tumors
SCCA
BCCA
Salivary Gland Tumors
Cholesteatoma
Keratosis Obturans
![Page 4: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/4.jpg)
• Broad based lesion
• Multiple Lesions
• Cortex intact
• Exostosis
![Page 5: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/5.jpg)
Exostosis
Location
Frequently bilateral
Along TS and TM suture lines
Arises near the annulus
Radiographic appearance
Broad base
Cortex intact
Other
Associated with prolonged cold water exposure
![Page 6: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/6.jpg)
• Single Lesion
• Pedunculated
• Unilateral
• No cortical invasion
• Osteoma
![Page 7: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/7.jpg)
Osteoma
Location
Unilateral
Arise anywhere lateral to IAC isthmus
Radiographic appearance
Cortex intact
Solitary pedunculated bony mass
Other
No association with cold water exposure
![Page 8: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/8.jpg)
• Single Lesion
• Destruction of bony cortex without remodeling
• Probable malignancy
![Page 9: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/9.jpg)
Malignant Lesions
Location
May arise within EAC or extend from pinna, post-
auricular sulcus, or parotid
Radiographic appearance
Involvement or invasion of soft tissue with destruction
of bony cortex
Types
Squamous cell CA
Basal cell CA
Salivary gland CA’s
![Page 10: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/10.jpg)
• Single Lesion
• Soft tissue density
• Erosion of adjacent bone with remodeling
• EAC Cholesteatoma
![Page 11: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/11.jpg)
Cholesteatoma of the EAC
Location
Typically posterior EAC just lateral to the TM
Radiographic appearance
Soft tissue mass
Destruction and remodeling of adjacent bone
Other
Exam may demonstrate pain, drainage, granulation, keratin debris, and even bony sequestra
![Page 12: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/12.jpg)
• Circumferential lesion
• Expansion of bony structures
• Cortex intact
• Keratosis Obturans
![Page 13: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/13.jpg)
Keratosis Obturans
Location
Involves majority of EAC
Radiographic appearance
Circumferential expansion of bony EAC
Soft tissue density occupies EAC
Other
Patients usually < 40 yrs
History of sinusitis or bronchiectasis
![Page 14: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/14.jpg)
Middle Ear and Mastoid
Infectious
Otitis Media
Mastoiditis
Paraganglioma
Glomus Tympanicum
Glomus Jugulare
Cholesteatoma
Congenital
Acquired
![Page 15: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/15.jpg)
![Page 16: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/16.jpg)
Otitis Media
Location Middle ear and mastoid
Radiographic appearance Soft tissue density in middle ear with possible
extension into mastoid cavity
Bony septae intact
Mastoid cortex intact
Air / fluid interface may be seen
Other Offending organisms commonly S. pneumoniae, M.
catarrhalis, H. influenzae.
![Page 17: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/17.jpg)
• Soft tissue density in mastoid
• Destruction of bony septae
• Cortex intact
• Coalescent Mastoiditis
![Page 18: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/18.jpg)
• Soft tissue opacity in mastoid
• Disruption of bony septae
• Mastoid cortex erosion
• Mastoiditis with possible Bezold’s abscess
![Page 19: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/19.jpg)
Mastoiditis
Location
Mastoid, middle ear, possible extension to adjacent
tissues
Radiographic appearance
Soft tissue density in mastoid cavity
Destruction of bony septae
Destruction of overlying bony cortex
Other
Offending organisms commonly S. pneumoniae, H.
influenzae, S. pyogenes, S. aureus
![Page 20: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/20.jpg)
Mastoiditis (cont)
Complications
Bezold’s abscess
Dural sinus thrombosis
Abscess (intracerebral, subdural, epidural)
Meningitis
![Page 21: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/21.jpg)
• Soft tissue opacity
• Small scutum erosion
• Ossicles intact
• Prussak’s space cholesteatoma
![Page 22: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/22.jpg)
• Soft tissue opacity
• Ossicles involved
• Minimal extension to mastoid
• No tegmen, facial nerve, or HSCC involvement
• Middle ear cholesteatoma with early mastoid involvement
![Page 23: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/23.jpg)
• Soft tissue opacity
• Scutum erosion
• Ossicles eroded
• Tegmen intact
• Erosion into HSCC
• Cholesteatoma with fistula
![Page 24: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/24.jpg)
• Soft tissue opacity
• Scutum erosion
• Ossicles eroded
• HSCC intact
• Tegmen dehiscent
• Herniation of temporal lobe into mastoid cavity
• Cholesteatoma with herniation of brain through tegmen defect
![Page 25: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/25.jpg)
Cholesteatoma
Location May occur in EAC, mastoid, or petrous apex
Radiographic appearance Soft tissue density
Usually arises in Prussak’s space
Erosion of adjacent bony structures Scutum
Ossicles
Tegmen
Mastoid cortex
Labyrinth
![Page 26: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/26.jpg)
![Page 27: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/27.jpg)
Glomus Tympanicum
Clinical Presents with pulsatile tinnitus, conductive hearing loss, and middle ear
lesion on otoscopy
Location May be confined to the middle ear space
Larger tumors grow into areas of least resistance with late bone erosion.
Radiographic appearance Soft tissue density originating from middle ear space
Expanding lesions may fill ME space without ossicle erosion
Bone involvement may begin near the jugular plate
Bone erosion has a moth-eaten appearance
MRI T1 and T2 have a salt & pepper appearance
Angiography reveals a blush, most often from the ascending pharyngeal artery
Small GT tumors localized to middle ear cleft require only CT for diagnosis.
![Page 28: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/28.jpg)
![Page 29: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/29.jpg)
![Page 30: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/30.jpg)
Glomus Jugulare
Location Tumor extension may involve infralabyrinthine area, carotid
canal, dura, or cavernous sinus.
Radiographic appearance Soft tissue density
Bone erosion has a moth-eaten appearance
MRI may be necessary to evaluate for intracranial extension
MRI T1 and T2 have a salt & pepper appearance
Angiography reveals a blush, most often from the ascending pharyngeal artery, but may involve the posterior auricular, occipital, maxillary, or internal carotid arteries.
Must rule-out an aberrant carotid artery or exposed jugular bulb.
![Page 31: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/31.jpg)
Labyrinth
Labyrinthitis
Labyrinthitis Ossificans
Otosclerosis
![Page 32: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/32.jpg)
• Bilateral cochlea and vestibule visible in non-contrast T1 image
• Right cochlea enhances on administration of Gadolinium on T1 image
• Labyrintihitis
![Page 33: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/33.jpg)
Labyrinthitis
Clinical findings SNHL
Vertigo
Radiographic findings Increased intensity of contrasted T1 images
Causes Viral
Bacterial
Autoimmune
Post-traumatic (may show pre-contrast T1 intensity)
![Page 34: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/34.jpg)
• Opacification of membranous labyrinth
• Labyrinthitis ossificans
![Page 35: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/35.jpg)
Labyrinthitis Ossificans
Clinical Important to rule out when considering cochlear implantation
Radiographic findings CT shows increasing density of membranous labyrinth.
MRI T2 may show a void instead of the normal fluid intensity within the cochlea
Causes Bacterial labyrinthitis
Viral labyrinthitis
Trauma
Autoimmune
![Page 36: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/36.jpg)
• Soft tissue density
• Located at anterior oval window
• Involves footplate of stapes
• Fenestral otosclerosis
![Page 37: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/37.jpg)
![Page 38: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/38.jpg)
• Soft tissue density
• Obscures oval window
• Involves entire bony labyrinth
• Retrofenestral otosclerosis
![Page 39: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/39.jpg)
Otosclerosis
Clinical May present with tinnitus or hearing loss
Female predominance
Schwartze sign
Radiographic findings Fenestral vs. Retrofenestral pattern
Small focus of soft tissue density anterior to the oval window
Narrowing of the oval window
Thickening of stapes footplate
Evaluation of facial nerve position and involvement of the round window are necessary.
![Page 40: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/40.jpg)
Internal Auditory Canal &
Cerebellopontine Angle
Acoustic Neuroma
Meningioma
Epidermoid
Arachnoid Cyst
Other neuromas
Paragangliomas
![Page 41: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/41.jpg)
Centered on Porus Acousticus
Acute angles to petrous bone
Often involves the IAC
Homogeneous enhancement
No dural tail
No calcifications
Acoustic Neuroma
![Page 42: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/42.jpg)
Acoustic Neuroma
Clinical Symptoms may involve cochlea, vestibular apparatus, facial nerve,
cerebellar or brainstem compression, or other cranial neuropathies.
Radiology CT
Non-contrast: usually isodense to brain, calcification is rare
IV Contrast: Over 90% of non-treated tumors enhance homogeneously
MRI T1 – isointense to brain, hyperintense to CSF
T2 – hyperintense to brain, iso/hypo-intense to CSF
Gadolinium – Intense enhancement of tumor on T1
General Features Centered on Porus Acousticus
Acute angles to temporal bone
Homogeneous enhancement
No dural tail
Rare calcifications
![Page 43: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/43.jpg)
Arise from surface of petrous bone
Obtuse angles to petrous bone
Uncommonly involves the IAC
Frequently with dural tail
Calcifications common
Pial vessel flow voids
Meningioma
![Page 44: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/44.jpg)
Meningioma
Clinical May present similar to AN with cochlear, vestibular,
facial nerve, or cerebellar symptoms.
Radiologic features Tumors generally hemispherical with obtuse angles to
petrous bone
Dural tail often present (50-75%)
May herniate into middle fossa (50%)
May show calcification (25%)
Pial blood vessels with flow voids may be present at the margins.
![Page 45: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/45.jpg)
![Page 46: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/46.jpg)
Epidermoid
Clinical Similar to acoustic neuroma and meningioma
Facial nerve paresis and facial twitching may occur
Location May arise within the temporal bone or in the CPA
Radiologic Features May dumbell into middle fossa or contralateral cistern
Highly variable in shape with a cauliflower surface appearance
CT usually shows a mass hypodense to CSF
MRI – homogeneous lesion T1 – isointense to CSF
T2 – isointense to CSF
DWI - moderate intensity
FLAIR – heterogeneous with hyperintense foci
![Page 47: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/47.jpg)
![Page 48: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/48.jpg)
Arachnoid Cyst
Clinical
Similar to acoustic neuroma and meningioma
Radiologic Features
Lesion often has a smooth surface
CT usually shows a mass isointense to CSF
MRI – homogeneous lesion
T1 – isointense to CSF
T2 – isointense to CSF
CISS – homogeneous lesion isointense to CSF
DWI – low intensity lesion
![Page 49: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/49.jpg)
Other Neuromas
CN VII Symptoms may be identical to acoustic schwannoma
Differentiation from acoustic schwannoma may not be possible by radiography unless lesion extends distal to geniculate ganglion.
CN IX – XI Jugular Foramen syndrome
Dysphagia
Hoarseness
Shoulder weakness
Enlargement of Jugular Foramen
CN XII Hemiatrophy of tongue
Enlargement of hypoglossal canal
![Page 50: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/50.jpg)
Petrous Apex
Cholesterol Granuloma
Cholesteatoma
Petrositis
![Page 51: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/51.jpg)
• Lesion arising from petrous apex
• MRI T1 intense
• MRI T2 intense
• Cholesterol Granuloma
![Page 52: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/52.jpg)
Cholesterol Granuloma
Clinical
Most common lesion of petrous apex
Often history of OM and allergies
Radiology
CT shows soft tissue density
MRI – both T1 & T2 are bright due to
presence of methemoglobin. A central
hypointensity may be present.
![Page 53: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/53.jpg)
• Soft tissue density of petrous apex
• Erosion of bony septae
• Cholesteatoma
![Page 54: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/54.jpg)
Cholesteatoma
May result from congenital or acquired disease
Radiology Identical to middle ear disease
Erosion of bony septae
May erode apical cortex
Primary CPA lesions may dumbell to contralateral side.
Soft tissue density on CT
MRI T1 – low signal intensity (differs from cholesterol granuloma)
T2 – high signal intensity
![Page 55: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/55.jpg)
• Fluid or soft tissue density in petrous
apex
• Possible erosion of bony septae of
petrous apex
• Enhancement on contrasted MRI
studies
• Petrositis
![Page 56: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/56.jpg)
• Soft tissue or fluid density of petrous apex
• Possible bony septae erosion
• MRI shows enhancement of dura as well as abscess cavity within
temporal lobe
• Acute petrositis with intracerebral abscess
![Page 57: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/57.jpg)
Petrositis
Clinical Presentation may include deep ipsilateral pain, otorrhea, cranial
neuropathies.
Gradenigo’s syndrome
Complications Meningitis
Intracranial abscesses
Venous sinus thrombosis
Radiologic Features Debris or soft tissue density within petrous apex
Possible destruction of bony septae
Possible cortical disruption
MRI may show enhancement of the lesion as well as surrounding meninges and cranial nerves.
![Page 58: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/58.jpg)
Ubiquitous Lesions
Dysplasia
Sarcoma
Metastasis
Trauma
![Page 59: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/59.jpg)
![Page 60: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/60.jpg)
• Polyostotic
• Cortex appears intact
• Areas of patchy sclerosis and
lucency (pagetoid pattern)
• Fibrous Dysplasia
![Page 61: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/61.jpg)
Dysplasia
Fibrous Dysplasia
Paget’s disease
Hyperparathyroidism
Osteogenesis Imperfecti
McCune-Albright Syndrome
![Page 62: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/62.jpg)
Sarcoma
Rhabdomyosarcoma
Tumor of childhood
May present with recurrent otorrhea
Often rapidly progressive and fatal
Chondrosarcoma
Usually occurs near petrous apex
Osteosarcoma
Giant Cell Tumor
![Page 63: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/63.jpg)
Metastasis
Solid organ metastasis
Breast
Kidney
Lung
Prostate
Hematologic metastasis
Melanoma
Lymphoma
![Page 64: Temporal Bone Lesions - utmb.edu](https://reader036.fdocuments.net/reader036/viewer/2022081801/586a09b31a28abe7148b9e7e/html5/thumbnails/64.jpg)
Bibliography
Bailey, Byron J. Head and Neck Surgery – Otolaryngology. Lippencott. New York, NY. 2001.
Brackmann, Shelton, Arriaga. Otologic Surgery. W.B. Saunders Compant, New York. 2001.
Fisch, Mattox. Microsurgery of the Skull Base. Georg Thieme. New York, NY. 1988.
Gloria-Cruz, et. al. “Metastases to Temporal Bones from Primary Nonsystemic Malignant Neoplasms.” Archives of Otolaryngology Head and Neck Surgery. 2000, 126: 209-214.
Lang, Johannes. Clinical Anatomy of the Posterior Cranial Fossa and its Foramina. Thieme Medical Publishers, Inc. 1991
McElveen, Dorfman. “Petroclival Tumors” Otolaryngology Clinics of North America. 2001, 34: 1219-1230.
Mendenhall, et al. “Management of Acoustic Neuroma” American Journal of Otolaryngology. 2004; 25: 38-47.
Myers, et. al. Operative Otolaryngology. Head and Neck Surgery. Saunders Company. Philadelphia, PA. 1997.
Som, Curtin. Head and Neck Imaging. Mosby. St. Louis, MO. 2003.