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Rare proliferative and inflammatory pathologies localized in the temporal bone – a review of the literature

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Roszkowski A., Witkowska A., Baranek P., Rzepakowska A., Wnuk E., Niemczyk K.
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Introduction: Proliferative-inflammatory pathologies may occupy the temporal bone, resulting in: hearing loss, vestibular dysfunction, and neuropathies from cranial nerve compression. Although their occurrence is episodic, the appropriate diagnostic procedure is extremely important to achieve expected therapeutic effect. Aim: The aim of study was characterization of selected proliferative-inflammatory pathologies that may occupy the temporal bone: fibrous dysplasia, inflammatory pseudotumor, osteoradionecrosis, and presentation of diagnostic methods for the differentiation of these diseases as well as discussion on appropriate therapeutic options. Fibrous dysplasia (FD) is a slowly progressive, benign bone disorder of unknown etiology characterized by abnormal proliferation of fibrous tissue. Inflammatory pseudotumor (IPT) is a rare, non-malignant inflammatory process of unknown etiology, characterized by connective tissue proliferation and infiltration of inflammatory cells. Osteoradionecrosis of the temporal bone (TB-ORN) is a rare but potentially fatal complication of radiotherapy for head and neck cancer. Results: Due to the similarity of symptoms with typical inflammatory conditions of middle ear (pain, otorrhea, hearing loss), selected disorders may be a dilemma regarding the diagnosis and proper further treatment. The clinical examination is mandatory, however radiological imaging may demonstrate the presence of specific changes and direct the diagnosis. The computed tomography (CT) of fibrous dysplasia shows the abnormal organization of the bone structure. Magnetic resonance (MRI), as the most sensitive for inflammatory pseudotumors, visualizes inflammatory infiltration in soft tissues. The CT of temporal bone identifies the erosion in the course of osteoradionecrosis. However in all cases the final diagnosis may be establish using histopathological examination and after exclusion of the neoplastic process.
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