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Metastatic Disease of the Temporal Bone: A Contemporary Review
Author(s) -
Jones Alexander J.,
Tucker Brady J.,
Novinger Leah J.,
Galer Chad E.,
Nelson Rick F.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29096
Subject(s) - medicine , temporal bone , asymptomatic , malignancy , palsy , metastasis , radiology , surgery , pathology , cancer , alternative medicine
Objectives To identify the frequency and primary site of metastatic pathologies to the temporal bone and characterize the associated symptomatology. Methods The MEDLINE, Embase, and Web of Science databases were systematically reviewed according to the PRISMA guidelines to identify all cases of pathologically confirmed distant temporal bone metastases published with English translation until October 2019. Descriptive statistics were performed. Results Out of 576 full‐length articles included for review, 109 met final criteria for data extraction providing 255 individual cases of distant temporal bone metastases. There was a male predominance (54.9%) with median age of 59.0 years (range 2–90). The most common locations of primary malignancy included the breasts (19.6%), lungs (16.1%), and prostate (8.6%). Most tumors were carcinomas of epithelial origin (75.3%) and predominantly adenocarcinoma (49.4%). The commonest metastatic sites encountered within the temporal bone were the petrous (72.0%) and mastoid (49.0%) portions. Bilateral temporal bone metastases occurred in 39.8% of patients. Patients were asymptomatic in 32.0% of cases. Symptomatic patients primarily reported hearing loss (44.3%), facial palsy (31.2%), and otalgia (16.6%) for a median duration of 1 month. Petrous lesions were associated with asymptomatic cases ( P = .001) while mastoid lesions more often exhibited facial palsy ( P = .026), otalgia ( P < .001), and otorrhea ( P < .001). Non‐carcinomatous tumors were associated with petrosal metastasis ( P = .025) and asymptomatic cases ( P = .109). Carcinomatous metastases more often presented with otalgia ( P = .003). Conclusions Temporal bone metastasis is uncommon but should be considered in patients with subacute otologic symptoms or facial palsy and history of distant malignancy. Laryngoscope , 131:1101–1109, 2021