Otology-Neurotology
Metastatic Disease of the Temporal Bone: A Contemporary Review
Alexander J. Jones MD,
Brady J. Tucker BS,
Leah J. Novinger MD, PhD,
Chad E. Galer MD,
Rick F. Nelson MD, PhD,
Corresponding Author
Alexander J. Jones MD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
A.J.J. and B.J.T. contributed equally to this work.
Send correspondence to Alexander J. Jones, MD, Indiana University School of Medicine, Department of OHNS, 1130 W. Michigan Street, Fesler Hall 400, Indianapolis, IN 46202. E-mail: [email protected]
Search for more papers by this authorBrady J. Tucker BS
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
A.J.J. and B.J.T. contributed equally to this work.
Search for more papers by this authorLeah J. Novinger MD, PhD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Search for more papers by this authorChad E. Galer MD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Search for more papers by this authorRick F. Nelson MD, PhD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Search for more papers by this authorAlexander J. Jones MD,
Brady J. Tucker BS,
Leah J. Novinger MD, PhD,
Chad E. Galer MD,
Rick F. Nelson MD, PhD,
Corresponding Author
Alexander J. Jones MD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
A.J.J. and B.J.T. contributed equally to this work.
Send correspondence to Alexander J. Jones, MD, Indiana University School of Medicine, Department of OHNS, 1130 W. Michigan Street, Fesler Hall 400, Indianapolis, IN 46202. E-mail: [email protected]
Search for more papers by this authorBrady J. Tucker BS
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
A.J.J. and B.J.T. contributed equally to this work.
Search for more papers by this authorLeah J. Novinger MD, PhD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Search for more papers by this authorChad E. Galer MD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Search for more papers by this authorRick F. Nelson MD, PhD
Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Otolaryngology—Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Search for more papers by this authorEditor's Note: This Manuscript was accepted for publication on August 22, 2020.
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
This manuscript was presented at the Triological Society Annual Meeting in the COSM 2020 Virtual Poster Session from May 15–June 15, 2020.
Abstract
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
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