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Bilateral Clinical Pathology of the Temporal Bone

Objectives/Hypothesis: The aim of this study is to indicate anatomic and immunologic peculiarities of the temporal bone which leave it vulnerable to traumatic, infectious and neoplastic insult. Study Design: Seven patients' cases are described in which the clinical pathology of the temporal bone was bilateral. The bilaterality of these cases serves to illustrate the anatomic points which are the focus of this study. Methods: This is a case series. Results: The seven paradigmatic cases are described and the relevant anatomy is explored. These are bilateral tuberculosis of the middle ear and mastoid, bilateral histiocytosis X, bilateral external canal amyloidosis, bilateral middle ear polyposis in Samter's triad, bilateral temporal bone fractures, bilateral middle cranial fossa encephaloceles, and bilateral congenital enlarged superior vestibular nerve canals. The thinness of the skull base, the many fluid-filled and tissue-filled canals which enter the temporal bone and the thinness of the tissues investing all the surfaces contribute to the temporal bone's vulnerability to trauma, infection and neoplasm. Conclusion: Cases of bilateral temporal bone pathology demonstrate the temporal bone's structural and immunologic weaknesses.