Clin Exp Otorhinolaryngol.  2019 Feb;12(1):27-32. 10.21053/ceo.2018.00171.

Clinical Characteristics of Temporal Bone Metastases

• Song K
• Park KW
• Heo JH
• Song IC
• Park YH
• Choi JW

• KMID: 2437488
• DOI: http://doi.org/10.21053/ceo.2018.00171

Abstract

OBJECTIVES
The purposes of this study were to evaluate the clinical characteristics of temporal bone metastasis (TBM) and to determine whether the characteristics differed according to primary malignancy.
METHODS
We retrospectively analyzed data on 20 patients diagnosed with TBM between January 2000 and January 2017. Demographics, the period from diagnosis of primary malignancy to TBM diagnosis, the period from TBM diagnosis to death, the type and staging of primary malignancy, otologic manifestations, and TBM sites were assessed. After the primary malignancies were divided into solid cancers and hematologic malignancies, each parameter was compared between the two groups.
RESULTS
The most common primary malignancy with TBM was lung cancer (45%). The most common otologic symptoms and signs were facial palsy (30.5%) and hearing loss (30.5%). The temporal squama (23%) and the facial nerve (20%) were the most commonly involved. Most TBMs occurred late in the disease process after the primary malignancy first metastasized to other organs. Hematologic malignancies metastasized significantly more frequently to the external auditory canal and the middle ear/mastoid compared to solid cancers (P=0.001 and P=0.004, respectively).
CONCLUSION
If otologic manifestations such as facial palsy and hearing loss are presented in patients at advanced stages of malignancy, TBM of primary malignancy should be suspected. In addition, hematologic malignancies tend to metastasize to the external auditory canal and the middle ear cleft more commonly than solid cancers do.

Keyword

Temporal Bone; Neoplasm Metastasis; Head and Neck Neoplasms; Leukemia

MeSH Terms

Demography
Diagnosis
Ear Canal
Ear, Middle
Facial Nerve
Facial Paralysis
Head and Neck Neoplasms
Hearing Loss
Hematologic Neoplasms
Humans
Leukemia
Lung Neoplasms
Neoplasm Metastasis*
Retrospective Studies
Temporal Bone*

Figure

• 

  Fig. 1. Otologic manifestations and sites of temporal bone metastases (TBMs). (A) Hearing loss (HL) and facial nerve palsy (FNP) were common symptoms and signs of TBM. (B) The temporal squama (TS) and the facial nerve (FN) were common sites of TBM. ASx, asymptomatic; PS, periauricular swelling; EAC, external auditory canal; IAC, internal auditory canal; PA, petrous apex; ME, middle ear cleft.

• 

  Fig. 2. Gantt chart showing periods (months) from diagnosis of primary malignancy to temporal bone metastasis (TBM) and from TBM to death. The time from the diagnosis of TBM to death was significantly shorter than the period from diagnosis of primary malignancy to TBM (P=0.011). a)Lost to follow-up. b)Alive with TBM. c)Diagnosis of TBM and primary malignancy at the same time.

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