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CONSIDERATIONS ON SUPPURATION OF THE PETROUS PYRAMID

CONSIDERATIONS ON SUPPURATION OF THE PETROUS PYRAMID Abstract "The petrous bone now occupies somewhat the position which the mastoid occupied twenty or thirty years ago." This statement was made by Ballance in 1919 and is even more applicable today, for the subject of suppuration of the petrous pyramid occupies the center of interest in otology. Our clinical experiences, our anatomic and surgical research and a comprehensive review of the literature prompt us to present this paper which deals with some of the less understood phases of suppuration of the petrous pyramid. Infection of the petrous portion of the temporal bone and a spread of the disease to the surrounding structures have been recorded many times in the past two hundred years. In 1740 Morgagni1 performed an autopsy on a boy of 12 years who had what was probably an acute exacerbation of chronic otitis media. Part of the account is as follows: "The pus had entered the References 1. Morgagni, G. B.: The Seats and Causes of Diseases , abridged and elucidated by William Cooke, Boston, Wells & Lilly, 1824, vol. 1, pp. 13 and 157. 2. Murray, Adolphus: Samml. auserl. Abhandl. zum Gebr. prakt. Aerzte , 1791, p. 19. 3. Kopetzky, S. J., and Almour, R.: (a) The Suppuration of the Petrous Pyramid; Pathology, Symptomatology and Surgical Treatment: I. , Ann. Otol., Rhin. & Laryng. 39:996 ( (Dec.) ) 1930 4. II. , Kopetzky Ann. Otol., Rhin. & Laryng. 40:157 ( (March) ) 1931 5. III. , Kopetzky Ann. Otol., Rhin. & Laryng. 40:396 ( (June) ) 1931 6. IV. , Kopetzky Ann. Otol., Rhin. & Laryng. 40:922 ( (Sept.) ) 1931. 7. Friedreich, J. B.: Hirnentzündung und Caries der Pars Petrosa des Schläfenbeines , Heidelberger klin. Ann. 5:393, 1829. 8. Leonard, Crosby: Case of Caries of Temporal Bone: Rapidly Fatal , M. J. London 2:1162, 1854. 9. Bigger, S. L.: Caries and Complete Removal of the Petrous Portion of the Temporal Bone , Dublin Hosp. Gaz. 2:349, 1855. 10. Uffenorde, W.: Zur Klinik der Fälle von Mittelohreiterung mit tiefen perilabyrinthären Herden , Arch. f. Ohren-, Nasen- u. Kehlkopfh. 105:87, 1920. 11. Eagleton, W. P.: Localized Bulbar Cisterna (Pontile) Meningitis, Facial Pain and Sixth Nerve Paralysis and Their Relation to Caries of the Petrous Apex , Arch. Surg. 20:386 ( (March) ) 1930. 12. von Luschka, H.: Anatomie: Die Nerven in der harten Hirnhaut , Tübingen, H. Laupp, 1850, p. 25. 13. Krause, F.: Hirnchirurgie , Deutsche Klin. 8:953, 1904. 14. Brouardel, P.: Des lesions du rocher et de l'apophyse mastoïde et de accidents qui en sont la conséquence , Bull. Soc. anat. de Paris 41:212 ( (May) ) 1866. 15. von Tröltsch: Anatomische Beiträge zur Lehre von der Ohreneiterung , Arch. f. Ohrenh. 4:96, 1867. 16. Berger, M.: Paralysie de l'acoustique et du trijmeau, parésie du facial, carie du rocher , Rec. d'ophth. 5:25, 1883. 17. Ostmann: Ueber die Beziehungen zwischen Auge und Ohr , Arch. f. Ophth. 43:1, 1897. 18. Gradenigo, G.: Sulla paralisi dell'abducente nelle otiti , Arch. ital. di otol. 18:414, 1907 19. Sulla paralisi dell'abducente di origine otitica , Gior. d. r. Accad. di med. di Torino 10:361, 1904. 20. Broeckaert, J.: Intervention par la voie supra auriculaire en cas de paralysie otique du meteur oculaire externe associée à la neuralgie du trigéminaux , Rev. de laryng. 2:209 ( (Sept.) ) 1915. 21. Profant, H. J.: Gradenigo Syndrome with a Consideration of Petrositis , Arch. Otolaryng. 13:347 ( (March) ) 1931. 22. Friesner, I., and Druss, J. G.: Osteitis of the Petrous Portion of the Temporal Bone , Arch. Otolaryng. 12:342 ( (Sept.) ) 1930. 23. Wilkinson, G.: A Case of Paralysis of the External Rectus Muscle Due to Abscess in the Apex of the Petrous Pyramid , J. Laryng., Otol. & Rhin. 29:409 ( (Aug.) ) 1918. 24. Rollin, H.: Beiträge zur Kenntnis der Mucosus-Otitis , Arch. f. Ohren-, Nasen- u. Kehlkopfh. 137:333, 1933.Crossref 25. Graham, H. B.: Two Cases of Perforation of the Petrous Portion of the Temporal Bone Due to Capsulated Bacteria , Ann. Otol., Rhin. & Laryng. 22:798, 1913. 26. Grunert: Anatomische und klinische Beiträge zur Lehre von den intracraniellen Complicationen der Otitis , München. med. Wchnschr. 44:1375, 1897. 27. Fowler, E. P.: Suppurations of the Petrous Tip , J. A. M. A. 102:1651 ( (May 9) ) 1934. 28. Myerson, M. C.; Rubin, H. W., and Gilbert, J. G.: Anatomic Studies of the Petrous Portion of the Temporal Bone , Arch. Otolaryng. 20:195 ( (Aug.) ) 1934. 29. Hagens, E. W.: Anatomy and Pathology of the Petrous Bone , Arch. Otolaryng. 19:556 ( (May) ) 1934. 30. Bowers, Wesley C.: Two Cases of Petrous Bone Abscess: Drainage, Recovery , Laryngoscope 38:412 ( (June) ) 1928. 31. Eagleton, Wells P.: Unlocking of the Petrous Pyramid for Localized Bulbar (Pontile) Meningitis Secondary to Suppuration of the Petrous Apex , Arch. Otolaryng. 13:386 ( (March) ) 1931. 32. Hilgerman, R.: The Involvement of the Gasserian Ganglion in Middle Ear Suppuration , Arch. Otolaryng. (March) 31:330, 1902. 33. Muck: Beiträge zur Kenntnis der otitischen Erkrankungen des Hirns, der Hirnhäute und der Blutleiter , Ztschr. f. Ohrenh. 37:174, 1900. 34. Sunde, E. A.: Infection of the Petrous Bone; Rationale of Treatment and Report of a Case , Arch. Otolaryng. 19:436 ( (April) ) 1934. 35. Frenckner, P.: Some Remarks on the Treatment of Apicitis (Petrositis) With or Without Gradenigo's Syndrome , Acta oto-laryng. 17:97, 1932. 36. Weeth, Charles: Fistula Through Arch of Superior Semicircular Canal , reported before the Ear, Nose and Throat Society of Brooklyn , (April) 1934. 37. Kopetzky, S. J., and Almour, R.: Empyema of the Petrous Apex: Further Observations and Case Reports , Ann. Otol., Rhin. & Laryng. 42:802, 1933. 38. Fletcher: Caries of Petrous Portion of Temporal Bone , London M. Gaz. 5:992, 1847. 39. Habermann: Mitteilung seltener Fälle , Verhandl. d. deutsch. otol. Gesellsch. 6:90, 1897. 40. Mayer, O.: Gradenigoscher Symptomenkomplex bei akuter Mittelohreneiterung: Operative Freilegung , Monatschr. f. Ohrenh. 63:970 ( (May) ) 1929. 41. Friesner, I., and Druss, J. G.: Pathways of Infection in Abscess of the Brain , Arch. Otolaryng. 13:532 ( (April) ) 1931. 42. Barr, J. S.: Remarks on Paralysis of the Sixth Cranial Consequent upon Chronic Purulent Middle Ear Disease , J. Laryng. & Otol. 23:553 ( (Oct.) ) 1908. 43. Bowers.25a 44. Gruvert.21 45. Kopetzky and Almour.3d 46. Muck.25d 47. Wilkinson.18 48. Goris, Un cas de chirurgie cérébrale pour complication d'otite moyenne chronique; guérison , Ann. d. mal. de l'oreille, du larynx 1:64, 1903. 49. Knapp, A.: Primary Cavernous Sinus Thrombosis Secondary to Osteomyelitis of the Petrous Pyramid , Arch. Otol. 35:437, 1906. 50. Jouty, A.: L'osteite de la pointe du rocher àpropos d'un cas opéré , Presse méd. 25:76, 1917. 51. Eagleton.8 52. Eagleton.25b 53. Aloin, H.: Apropos des ostéites profondes de la pointe du rocher , Ann. d'oto-laryng. 3:194, 1933. 54. Greenfield, S. D.: Conservative Treatment of Petrositis , Arch. Otolaryng. 20:172 ( (Aug.) ) 1934.Crossref 55. Seydell, E. M.: Surgical Treatment of Suppuration of the Petrosal Pyramid , Ann. Otol., Rhin. & Laryng. 42:455, 1933. 56. Bowers.25a 57. Eagleton.3b 58. Grunert.21 59. Muck.25d 60. Myerson, Rubin and Gilbert (case 4). 61. Streit, H.: Ein Operationsverfahren zur Eröffnung tiefgelegener von der Spitze der Felsbeinpyramide ausgehender Epiduralabscesse , Arch. f. Ohrenh. 57:169, 1903. 62. Brunner, H.: Purulent Diseases of the Petrous Portion of the Temporal Bone , Ztschr. f. Hals-, Nasen- u. Ohrenh. 25:383 ( (Feb.) ) 1930. 63. Courville, Cyril B., and Nielsen, J. M.: Fatal Complications of Otitis Media with Particular Reference to Intracranial Lesions in a Series of Ten Thousand Autopsies , Arch. Otolaryng. 19:451 ( (April) ) 1934. 64. Atkins, R. T.: Suppuration of the Petrous Pyramid: Rupture of Extradural Abscess Over the Apex , Laryngoscope 38:404 ( (June) ) 1928. 65. Ballance, Charles A.: Surgery of the Temporal Bone , New York, The Macmillan Company, 1919, pp. 16 and 57. 66. Richards, John D.: The Petrous Pyramid: Its Surgical Anatomy and the Technic of the Operation for Its Removal , Am. J. Surg. 2:11 ( (Jan.) ) 1927. 67. Voss, O.: Pyramidenspitzeneiterungen (Petrositis) an der Hand von 12 selbstbeobachteten Fällen , Acta oto-laryng. 15:469, 1931. 68. Ramadier, J.; Buillon, H., and Becker: Etude anatomique d'une voie d'abord des cellules de la pointe du rocher , Ann. d'anat. path. 9:597, 1932. 69. Myerson, M. C.; Rubin, H. W., and Gilbert, J. G.: Improved Operative Technic for Suppuration of the Petrous Apex , Arch. Otolaryng. 19:699 ( (June) ) 1934. 70. Ruttin, E.: Zur Klinik und Operation der Pyramidenspitzeneiterung und des periapikalen extradurallen Abscesses , Zentralbl. f. Hals-, Nasen- u. Ohrenh. 22:204, 1933. 71. This case and case 3 were reported in separate articles, but the descriptions are repeated briefly because of certain unusual aspects. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

CONSIDERATIONS ON SUPPURATION OF THE PETROUS PYRAMID

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References (59)

Publisher
American Medical Association
Copyright
Copyright © 1935 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1935.00640030073006
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Abstract

Abstract "The petrous bone now occupies somewhat the position which the mastoid occupied twenty or thirty years ago." This statement was made by Ballance in 1919 and is even more applicable today, for the subject of suppuration of the petrous pyramid occupies the center of interest in otology. Our clinical experiences, our anatomic and surgical research and a comprehensive review of the literature prompt us to present this paper which deals with some of the less understood phases of suppuration of the petrous pyramid. Infection of the petrous portion of the temporal bone and a spread of the disease to the surrounding structures have been recorded many times in the past two hundred years. In 1740 Morgagni1 performed an autopsy on a boy of 12 years who had what was probably an acute exacerbation of chronic otitis media. Part of the account is as follows: "The pus had entered the References 1. Morgagni, G. B.: The Seats and Causes of Diseases , abridged and elucidated by William Cooke, Boston, Wells & Lilly, 1824, vol. 1, pp. 13 and 157. 2. Murray, Adolphus: Samml. auserl. Abhandl. zum Gebr. prakt. Aerzte , 1791, p. 19. 3. Kopetzky, S. J., and Almour, R.: (a) The Suppuration of the Petrous Pyramid; Pathology, Symptomatology and Surgical Treatment: I. , Ann. Otol., Rhin. & Laryng. 39:996 ( (Dec.) ) 1930 4. II. , Kopetzky Ann. Otol., Rhin. & Laryng. 40:157 ( (March) ) 1931 5. III. , Kopetzky Ann. Otol., Rhin. & Laryng. 40:396 ( (June) ) 1931 6. IV. , Kopetzky Ann. Otol., Rhin. & Laryng. 40:922 ( (Sept.) ) 1931. 7. Friedreich, J. B.: Hirnentzündung und Caries der Pars Petrosa des Schläfenbeines , Heidelberger klin. Ann. 5:393, 1829. 8. Leonard, Crosby: Case of Caries of Temporal Bone: Rapidly Fatal , M. J. London 2:1162, 1854. 9. Bigger, S. L.: Caries and Complete Removal of the Petrous Portion of the Temporal Bone , Dublin Hosp. Gaz. 2:349, 1855. 10. Uffenorde, W.: Zur Klinik der Fälle von Mittelohreiterung mit tiefen perilabyrinthären Herden , Arch. f. Ohren-, Nasen- u. Kehlkopfh. 105:87, 1920. 11. Eagleton, W. P.: Localized Bulbar Cisterna (Pontile) Meningitis, Facial Pain and Sixth Nerve Paralysis and Their Relation to Caries of the Petrous Apex , Arch. Surg. 20:386 ( (March) ) 1930. 12. von Luschka, H.: Anatomie: Die Nerven in der harten Hirnhaut , Tübingen, H. Laupp, 1850, p. 25. 13. Krause, F.: Hirnchirurgie , Deutsche Klin. 8:953, 1904. 14. Brouardel, P.: Des lesions du rocher et de l'apophyse mastoïde et de accidents qui en sont la conséquence , Bull. Soc. anat. de Paris 41:212 ( (May) ) 1866. 15. von Tröltsch: Anatomische Beiträge zur Lehre von der Ohreneiterung , Arch. f. Ohrenh. 4:96, 1867. 16. Berger, M.: Paralysie de l'acoustique et du trijmeau, parésie du facial, carie du rocher , Rec. d'ophth. 5:25, 1883. 17. Ostmann: Ueber die Beziehungen zwischen Auge und Ohr , Arch. f. Ophth. 43:1, 1897. 18. Gradenigo, G.: Sulla paralisi dell'abducente nelle otiti , Arch. ital. di otol. 18:414, 1907 19. Sulla paralisi dell'abducente di origine otitica , Gior. d. r. Accad. di med. di Torino 10:361, 1904. 20. Broeckaert, J.: Intervention par la voie supra auriculaire en cas de paralysie otique du meteur oculaire externe associée à la neuralgie du trigéminaux , Rev. de laryng. 2:209 ( (Sept.) ) 1915. 21. Profant, H. J.: Gradenigo Syndrome with a Consideration of Petrositis , Arch. Otolaryng. 13:347 ( (March) ) 1931. 22. Friesner, I., and Druss, J. G.: Osteitis of the Petrous Portion of the Temporal Bone , Arch. Otolaryng. 12:342 ( (Sept.) ) 1930. 23. Wilkinson, G.: A Case of Paralysis of the External Rectus Muscle Due to Abscess in the Apex of the Petrous Pyramid , J. Laryng., Otol. & Rhin. 29:409 ( (Aug.) ) 1918. 24. Rollin, H.: Beiträge zur Kenntnis der Mucosus-Otitis , Arch. f. Ohren-, Nasen- u. Kehlkopfh. 137:333, 1933.Crossref 25. Graham, H. B.: Two Cases of Perforation of the Petrous Portion of the Temporal Bone Due to Capsulated Bacteria , Ann. Otol., Rhin. & Laryng. 22:798, 1913. 26. Grunert: Anatomische und klinische Beiträge zur Lehre von den intracraniellen Complicationen der Otitis , München. med. Wchnschr. 44:1375, 1897. 27. Fowler, E. P.: Suppurations of the Petrous Tip , J. A. M. A. 102:1651 ( (May 9) ) 1934. 28. Myerson, M. C.; Rubin, H. W., and Gilbert, J. G.: Anatomic Studies of the Petrous Portion of the Temporal Bone , Arch. Otolaryng. 20:195 ( (Aug.) ) 1934. 29. Hagens, E. W.: Anatomy and Pathology of the Petrous Bone , Arch. Otolaryng. 19:556 ( (May) ) 1934. 30. Bowers, Wesley C.: Two Cases of Petrous Bone Abscess: Drainage, Recovery , Laryngoscope 38:412 ( (June) ) 1928. 31. Eagleton, Wells P.: Unlocking of the Petrous Pyramid for Localized Bulbar (Pontile) Meningitis Secondary to Suppuration of the Petrous Apex , Arch. Otolaryng. 13:386 ( (March) ) 1931. 32. Hilgerman, R.: The Involvement of the Gasserian Ganglion in Middle Ear Suppuration , Arch. Otolaryng. (March) 31:330, 1902. 33. Muck: Beiträge zur Kenntnis der otitischen Erkrankungen des Hirns, der Hirnhäute und der Blutleiter , Ztschr. f. Ohrenh. 37:174, 1900. 34. Sunde, E. A.: Infection of the Petrous Bone; Rationale of Treatment and Report of a Case , Arch. Otolaryng. 19:436 ( (April) ) 1934. 35. Frenckner, P.: Some Remarks on the Treatment of Apicitis (Petrositis) With or Without Gradenigo's Syndrome , Acta oto-laryng. 17:97, 1932. 36. Weeth, Charles: Fistula Through Arch of Superior Semicircular Canal , reported before the Ear, Nose and Throat Society of Brooklyn , (April) 1934. 37. Kopetzky, S. J., and Almour, R.: Empyema of the Petrous Apex: Further Observations and Case Reports , Ann. Otol., Rhin. & Laryng. 42:802, 1933. 38. Fletcher: Caries of Petrous Portion of Temporal Bone , London M. Gaz. 5:992, 1847. 39. Habermann: Mitteilung seltener Fälle , Verhandl. d. deutsch. otol. Gesellsch. 6:90, 1897. 40. Mayer, O.: Gradenigoscher Symptomenkomplex bei akuter Mittelohreneiterung: Operative Freilegung , Monatschr. f. Ohrenh. 63:970 ( (May) ) 1929. 41. Friesner, I., and Druss, J. G.: Pathways of Infection in Abscess of the Brain , Arch. Otolaryng. 13:532 ( (April) ) 1931. 42. Barr, J. S.: Remarks on Paralysis of the Sixth Cranial Consequent upon Chronic Purulent Middle Ear Disease , J. Laryng. & Otol. 23:553 ( (Oct.) ) 1908. 43. Bowers.25a 44. Gruvert.21 45. Kopetzky and Almour.3d 46. Muck.25d 47. Wilkinson.18 48. Goris, Un cas de chirurgie cérébrale pour complication d'otite moyenne chronique; guérison , Ann. d. mal. de l'oreille, du larynx 1:64, 1903. 49. Knapp, A.: Primary Cavernous Sinus Thrombosis Secondary to Osteomyelitis of the Petrous Pyramid , Arch. Otol. 35:437, 1906. 50. Jouty, A.: L'osteite de la pointe du rocher àpropos d'un cas opéré , Presse méd. 25:76, 1917. 51. Eagleton.8 52. Eagleton.25b 53. Aloin, H.: Apropos des ostéites profondes de la pointe du rocher , Ann. d'oto-laryng. 3:194, 1933. 54. Greenfield, S. D.: Conservative Treatment of Petrositis , Arch. Otolaryng. 20:172 ( (Aug.) ) 1934.Crossref 55. Seydell, E. M.: Surgical Treatment of Suppuration of the Petrosal Pyramid , Ann. Otol., Rhin. & Laryng. 42:455, 1933. 56. Bowers.25a 57. Eagleton.3b 58. Grunert.21 59. Muck.25d 60. Myerson, Rubin and Gilbert (case 4). 61. Streit, H.: Ein Operationsverfahren zur Eröffnung tiefgelegener von der Spitze der Felsbeinpyramide ausgehender Epiduralabscesse , Arch. f. Ohrenh. 57:169, 1903. 62. Brunner, H.: Purulent Diseases of the Petrous Portion of the Temporal Bone , Ztschr. f. Hals-, Nasen- u. Ohrenh. 25:383 ( (Feb.) ) 1930. 63. Courville, Cyril B., and Nielsen, J. M.: Fatal Complications of Otitis Media with Particular Reference to Intracranial Lesions in a Series of Ten Thousand Autopsies , Arch. Otolaryng. 19:451 ( (April) ) 1934. 64. Atkins, R. T.: Suppuration of the Petrous Pyramid: Rupture of Extradural Abscess Over the Apex , Laryngoscope 38:404 ( (June) ) 1928. 65. Ballance, Charles A.: Surgery of the Temporal Bone , New York, The Macmillan Company, 1919, pp. 16 and 57. 66. Richards, John D.: The Petrous Pyramid: Its Surgical Anatomy and the Technic of the Operation for Its Removal , Am. J. Surg. 2:11 ( (Jan.) ) 1927. 67. Voss, O.: Pyramidenspitzeneiterungen (Petrositis) an der Hand von 12 selbstbeobachteten Fällen , Acta oto-laryng. 15:469, 1931. 68. Ramadier, J.; Buillon, H., and Becker: Etude anatomique d'une voie d'abord des cellules de la pointe du rocher , Ann. d'anat. path. 9:597, 1932. 69. Myerson, M. C.; Rubin, H. W., and Gilbert, J. G.: Improved Operative Technic for Suppuration of the Petrous Apex , Arch. Otolaryng. 19:699 ( (June) ) 1934. 70. Ruttin, E.: Zur Klinik und Operation der Pyramidenspitzeneiterung und des periapikalen extradurallen Abscesses , Zentralbl. f. Hals-, Nasen- u. Ohrenh. 22:204, 1933. 71. This case and case 3 were reported in separate articles, but the descriptions are repeated briefly because of certain unusual aspects.

Journal

Archives of Otolaryngology – American Medical Association

Published: Jul 1, 1935

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