SECONDARY TUMOR OF THE TEMPORAL BONE WITH INTERNAL AUDITORY MEATUS INVOLVEMENT

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  • KUDO YASUHIRO
    Department of Otolaryngology, National Oji Hospital
  • KAGA KIMITAKA
    Department of Otolaryngology, Faculty of Medicine, University of Tokyo
  • SAKURAI HISAO
    Department of Otolaryngology, Faculty of Medicine, Teikyo University
  • OHIRA YASUYUKI
    Department of Otolaryngology, Saitama Prefectural Medical Center for Children

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Other Title
  • 内耳道に腫瘍を認める二次性側頭骨腫瘍の病理組織学的検討
  • HISTOPATHOLOGICAL STUDY

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Description

Nineteen cases of secondary tumor of the temporal bone with involvement of the internal auditory meatus (IAM) were studied. The cases were classified into 4 invasion modes; direct extension from head and neck tumors (12 cases), hematological dissemination (3 cases), diffuse leptomeningeal carcinomatosis (3 cases), and direct extension of tumors from the intracranium (1 case).<BR>There were some differences in the manner in which the tumor had spread among these 4 modes. In most cases involving “direct extension from head and neck tumors”, the tumor had invaded the pyramis, and then the Eustachian tube and the middle ear. When the inner ear or the IAM was involved, it was directly invaded by massive tumor. In all cases of “hematological dissemination”, metastatic tumor was found bilaterally, but there were some differences in the manner of invasion between the two sides. In “leptomeningeal carcinomatosis” and “intracranial tumor”, the tumor had invaded the temporal bone bilaterally via the IAM.<BR>In the IAM, cochlear and inferior vestibular nerves were more vulnerable to tumor invasion than facial and superior vestibular nerves. It was suggested that there are some differences in vulnerability to tumor invasion between the superior and inferior vestibular nerves.<BR>The bottom of the IAM presented a barrier-like effect against the spread of tumor from the IAM to the labyrinth. In some cases, however, there was massive tumor invasion of the internal ear directly from the IAM.<BR>Whether denervation of the ganglionic neurons (spiral or vestibular) causes secondary degeneration of peripheral sensory endorgans remains controversial. In some cases in our series, degeneration of the auditory or vestibular peripheral organs might be attributed to denervation of neurons in the spiral or vestibular ganglia. In other cases, however, auditory and vestibular peripheral organs remained intact despite severe degeneration of ganglionic neurons.

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 98 (6), 989-999,1077, 1995

    Japanese Society of Otorhinolaryngology-Head and neck surgery

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