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Differential Diagnosis of Temporal Bone and Skull Base Lesions



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Differential Diagnosis of Temporal Bone and Skull Base Lesions December 2001 TITLE Differential Diagnosis of Temporal Bone and Skull Base Lesions SOURCE Grand Rounds Presentation UTMB Dept of Otolaryngology DATE December 19 2001 RESIDENT PHYSICIAN Russell D Briggs M D FACULTY ADVISOR Arun Gadre M D SERIES EDITORS Francis B Quinn Jr MD and Matthew W Ryan MD ARCHIVIST Melinda Stoner Quinn MSICS This material was prepared by resident physicians in partial fulfillment of educational requirements established for the Postgraduate Training Program of the UTMB Department of Otolaryngology Head and Neck Surgery and was not intended for clinical use in its present form It was prepared for the purpose of stimulating group discussion in a conference setting No warranties either express or implied are made with respect to its accuracy completeness or timeliness The material does not necessarily reflect the current or past opinions of members of the UTMB faculty and should not be used for purposes of diagnosis or treatment without consulting appropriate literature sources and informed professional opinion Introduction A wide spectrum of diseases involves the temporal bone and skull base Primary tumors inflammatory processes and metastatic disease are a few of the many abnormalities that can exist within the temporal bone and skull base With the advent of high resolution computed tomography HRCT and magnetic resonance imaging MRI the diagnosis of many of these abnormalities is more readily apparent By classifying these processes based on location and identifying the common imaging characteristics a relatively straightforward differential diagnosis can be formulated Lesions of the Middle Ear and Mastoid Cholesteatoma Epidermoids Cholesteatomas are soft tissues masses caused by aberrant accumulation of keratin debris within a sac of squamous epithelium These are not true neoplasms as they do not exhibit cellular growth rather they are the result of squamous epithelial migration or



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