Raymond Mallory J, Ottinger Allie, Rowley M Andrew, Bobian Michael, Dornhoffer Jim, Brennan Emily, Rizk Habib G
Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC.
Otol Neurotol. 2024 Apr 1;45(4):362-375. doi: 10.1097/MAO.0000000000004141. Epub 2024 Feb 28.
To examine the otologic and neurotologic symptoms, physical examination findings, and imaging features secondary to hematologic malignancies.
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases, including PubMed, Scopus, and CINAHL, were searched for articles including patients with otologic manifestations of leukemia, lymphoma and multiple myeloma. Data collected included patient and study demographics, specific hematologic malignancy, timing and classification of otologic symptoms, physical examination findings, imaging features and methods of diagnosis. Pooled descriptive analysis was performed.
Two hundred seventy-two articles, of which 255 (93.8%) were case reports and 17 (6.2%) were case series, reporting on 553 patients were identified. Otologic manifestations were reported on 307 patients with leukemia, 204 patients with lymphoma and 42 patients with multiple myeloma. Hearing loss and unilateral facial palsy were the most common presenting symptoms for 111 reported subjects with leukemia (n = 46, 41.4%; n = 43, 38.7%) and 90 with lymphoma (n = 38, 42.2%; n = 39, 43.3%). Hearing loss and otalgia were the most common presenting symptoms for 21 subjects with multiple myeloma (n = 10, 47.6%; n = 6, 28.6%). Hearing loss and unilateral facial palsy were the most common otologic symptoms indicative of relapse in subjects with leukemia (n = 14, 43.8%) and lymphoma (n = 5, 50%).
Hearing loss, facial palsy, and otalgia might be the first indication of a new diagnosis or relapse of leukemia, lymphoma, or multiple myeloma. Clinicians should have a heightened level of suspicion of malignant etiologies of otologic symptoms in patients with current or medical histories of these malignancies.
研究血液系统恶性肿瘤继发的耳科和神经耳科症状、体格检查结果及影像学特征。
按照系统评价和Meta分析的首选报告项目指南，检索包括PubMed、Scopus和CINAHL在内的数据库，查找有关白血病、淋巴瘤和多发性骨髓瘤耳科表现患者的文章。收集的数据包括患者和研究的人口统计学信息、特定的血液系统恶性肿瘤、耳科症状的发生时间和分类、体格检查结果、影像学特征及诊断方法。进行汇总描述性分析。
共识别出272篇文章，其中255篇（93.8%）为病例报告，17篇（6.2%）为病例系列，报告了553例患者。307例白血病患者、204例淋巴瘤患者和42例多发性骨髓瘤患者有耳科表现。听力损失和单侧面瘫是111例报告的白血病患者（n = 46，41.4%；n = 43，38.7%）和90例淋巴瘤患者（n = 38，42.2%；n = 39，43.3%）最常见的首发症状。听力损失和耳痛是21例多发性骨髓瘤患者（n = 10，47.6%；n = 6，28.6%）最常见的首发症状。听力损失和单侧面瘫是白血病患者（n = 14，43.8%）和淋巴瘤患者（n = 5，50%）最常见的提示复发的耳科症状。
听力损失、面瘫和耳痛可能是白血病、淋巴瘤或多发性骨髓瘤新诊断或复发的首要迹象。对于有这些恶性肿瘤现病史或既往史的患者，临床医生应提高对耳科症状恶性病因的怀疑程度。
