Abstract
Problem
There are reports of hearing loss, tinnitus, and/or vertigo in patients with leukemia. However, there is no human temporal bone study of a large number of cases specific to acute lymphocytic leukemia. We studied the correlation between clinical otologic complaints and temporal bone histopathology in patients with this disease.
Methods
Clinical otologic complaints and histologic findings were evaluated in 13 patients (25 temporal bones) with acute lymphocytic leukemia.
Results
Nine patients had a history of clinical otologic complaints including: hearing loss in 5 patients; otalgia in 3; otorrhea in 3; and dizziness in 2. Hemorrhage was seen most commonly in the middle ear in 10 patients, but was also evident in the cochlea in 5 and the vestibular labyrinth in 2. Leukemic infiltration was observed in the petrous apex in 12 patients, in the middle ear in 6, the cochlea in 5, the vestibular labyrinth in 2 and the internal auditory canal in 3. Inflammatory cell infiltration was also seen in the cochlear labyrinth in 4 patient, the vestibular labyrinth in 5 and the modiolus in 1. Otitis media with hyperplasia of subepithelial fibrous tissue was seen in 10 patients. Three patients had granulation tissue extending into the middle ear or mastoid.
Conclusion
Ear involvement is a common finding in patients with acute lymphocytic leukemia.
Significance
With prolonged survival due to new chemotherapeutics, the diagnosis and treatment of non-hematopoietic system complications such as ear problems due to acute lymphocytic leukemia have become more important.
Support
International Hearing Foundation, Hubbard Foundation, Starkey Foundation.
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