Basioccipital meningocele.
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Biomedical subjects
Publications and source records attributed to G T Nager.
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Fibrous dysplasia is a fairly common, localized misdifferentiation of the bone-forming mesenchyme affecting a single or many bones, in which skeletal aberrations represent the cardinal feature, but in which certain endocrinopathies, abnormal pigmentation of skin and mucous membrane, and occasionally other abnormalities form part of the entire disease process. The craniofacial skeleton is one of its predilective sites and therefore the temporal bone may become involved. In such instances the disease manifests itself with 1) progressive loss of hearing, 2) increasing obliteration of the external ear canal, and 3) enlargement and distortion of the temporal bone. The first part of this communication is concerned with a review of the clinical and pathological aspects of the disease in general. The second part is concerned with a discussion of the clinical manifestations in the temporal bone, based upon analysis of the entire literature and the authors' personal experience. The indications for surgical intervention include 1) maintenance of a normal outer ear canal, 2) preservation of cochlear and vestibular function, and 3) prevention of secondary complications.
Modern otologic surgery revolves around the use of the operating microscope. The surgeon must have a thorough knowledge of all structures in the temporal bone, particularly since surgery may now be directed to areas in its deeper portions. Of concern here is the whereabouts of the facial canal in its complex course through the temporal bone. A detailed descriptive anatomy with emphasis on the relations of the facial canal to adjacent structures is presented. The variations in the course of the facial canal are discussed. The location of dehiscences in the bony canal wall are described. Finally, great stress is laid upon presentation of these anomalies known to us which can occur in the course of the facial nerve through the temporal bone. These anomalies have clinical and surgical significance.
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