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Published on: February 29, 2020
Temporal bone histiocytosis in children: a systematic review
Francesca Galluzzi1, Werner Garavello2
1Department of Otorhinolaryngology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
Objective:
To analyze the diagnosis, treatment, and outcomes of temporal bone histiocytosis (TBH) in children.
Methods:
A systematic review was conducted based on PRISMA guidelines. A literature review on the databases PubMed and Embase was conducted. Risk of bias was evaluated using the MINOR Score.
Results:
Eight retrospective studies with 84 subjects were included. The mean age was 3 years with a prevalence of male. Clinical features comprehend otorrhea, otalgia, recurrent external and media otitis, postauricular swelling, dermatitis, and external ear canal polyps/mass. 52/84 (62 %) children had single system involvement, and most extra-temporal bone involvement was pituitary gland with diabetes insipidus. CT scan revealed osteolytic lesions without surrounding sclerosis and punched-out lesions centered in the squamous part. The subsites most involved were: mastoid, external and middle ears and temporal squama, less frequently optic capsule and petrous apex. One-third of cases had bilateral involvement. MRI was helpful for detecting intracranial lesions. Hearing loss was conductive (20 cases), sensorineural (4) and mixed (5). Treatment strategies included: CT and RT, CT alone, surgery and RT, and surgery and CT. The overall recurrence rate was 20.2 % (17/84). The duration of follow-up ranged from 6 weeks to 18 years. Temporal bone complications were facial palsy, cholesteatoma, and chronic dermatitis.
Conclusion:
Management of temporal bone histiocytosis in children requires a multidisciplinary approach. The role of otolaryngologist is crucial for the early diagnosis and surgical treatment of selected cases. A long-term follow-up is necessary to detect recurrences and otological complications.
Insights
Temporal bone histiocytosis (TBH) in children presents with ear symptoms and osteolytic lesions. Management requires a multidisciplinary approach with long-term follow-up for potential recurrences and complications.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Radiology
- Pediatric Endocrinology
Background:
- Temporal bone histiocytosis (TBH) is a rare condition affecting children.
- Early diagnosis and treatment are crucial for managing this condition.
Purpose of the Study:
- To analyze the diagnosis, treatment, and outcomes of temporal bone histiocytosis (TBH) in children.
- To highlight the importance of a multidisciplinary approach and long-term follow-up.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Literature search conducted on PubMed and Embase databases.
- Risk of bias assessed using the MINOR Score.
Main Results:
- Eight retrospective studies involving 84 children were analyzed.
- Common symptoms include otorrhea, otalgia, and recurrent otitis; pituitary involvement with diabetes insipidus was noted.
- CT scans showed osteolytic lesions; MRI aided in detecting intracranial lesions. Recurrence rate was 20.2%.
Conclusions:
- Management of pediatric TBH necessitates a multidisciplinary strategy.
- Otolaryngologists play a key role in early diagnosis and surgical intervention.
- Long-term follow-up is essential for monitoring recurrences and otological complications.
