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.
Laryngoscope. 2021 May;131(5):1101-1109. doi: 10.1002/lary.29096. Epub 2020 Sep 17.
To identify the frequency and primary site of metastatic pathologies to the temporal bone and characterize the associated symptomatology.
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.
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).
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.
确定颞骨转移性病变的频率和主要部位，并描述其相关症状。
根据 PRISMA 指南，系统地检索了 MEDLINE、Embase 和 Web of Science 数据库，以确定截至 2019 年 10 月所有经病理证实的伴有英文翻译的远处颞骨转移病例。进行了描述性统计分析。
在纳入的 576 篇全文文章中，有 109 篇最终符合数据提取标准，共提供了 255 例远处颞骨转移的病例。男性占优势（54.9%），中位年龄为 59.0 岁（范围 2-90 岁）。最常见的原发恶性肿瘤部位包括乳房（19.6%）、肺（16.1%）和前列腺（8.6%）。大多数肿瘤来源于上皮源性癌（75.3%），主要为腺癌（49.4%）。在颞骨内最常见的转移部位是岩部（72.0%）和乳突部（49.0%）。双侧颞骨转移发生在 39.8%的患者中。32.0%的患者无症状。有症状的患者主要表现为听力损失（44.3%）、面瘫（31.2%）和耳痛（16.6%），中位持续时间为 1 个月。岩部病变与无症状病例相关（P =.001），而乳突病变更常出现面瘫（P =.026）、耳痛（P < .001）和耳漏（P < .001）。非癌性肿瘤与岩部转移（P =.025）和无症状病例（P =.109）相关。癌性转移更常出现耳痛（P =.003）。
颞骨转移并不常见，但对于有亚急性耳科症状或面瘫和远处恶性肿瘤病史的患者，应考虑颞骨转移的可能性。喉镜，131：1101-1109，2021。
