American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 32, Issue 1 , Pages 13-18, January 2011

Pathologic correlations of otologic symptoms in acute lymphocytic leukemia☆

  • Kyoichi Terao, MD, PhD

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • International Hearing Foundation, Minneapolis, Minnesota, USA
    • Department of Otolaryngology, Kinki University School of Medicine, Osaka, Japan
    • ,
  • Sebahattin Cureoglu, MD

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
    • Corresponding Author InformationCorresponding author. Department of Otolaryngology, University of Minnesota, Room 210, Lions Research Building, 2001, 6th Street, SE, Minneapolis, MN 55455, USA. Tel.: +1 612 626 9883; fax: +1 612 626 9871.
    • ,
  • Patricia A. Schachern, BS

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • ,
  • Michael M. Paparella, MD

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • International Hearing Foundation, Minneapolis, Minnesota, USA
    • Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
    • ,
  • Norimasa Morita, MD, PhD

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • International Hearing Foundation, Minneapolis, Minnesota, USA
    • ,
  • Shigenobu Nomiya, MD, PhD

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • International Hearing Foundation, Minneapolis, Minnesota, USA
    • ,
  • Taro Inagaki, MD, PhD

      Affiliations

    • Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
    • International Hearing Foundation, Minneapolis, Minnesota, USA
    • ,
  • Kazunori Mori, MD, PhD

      Affiliations

    • Department of Otolaryngology, Kinki University School of Medicine, Osaka, Japan
    • ,
  • Kiyotaka Murata, MD, PhD

      Affiliations

    • Department of Otolaryngology, Kinki University School of Medicine, Osaka, Japan

Received 30 June 2009 published online 21 December 2009.

Abstract 

Objectives

To assess the clinicopathologic correlations of otologic complaints in patients with acute lymphocytic leukemia.

Design

Otologic complaints and histologic findings were evaluated in 25 temporal bones of 13 acute lymphocytic leukemia patients.

Results

Nine patients had a history of otologic complaints, including hearing loss, otalgia, otorrhea, and vertigo in 5, 3, 3, and 2 patients, respectively. Hemorrhage was most commonly observed in the middle ear (6 patients, 9 temporal bones) and was also observed in cochlea (4 patients, 4 temporal bones), and vestibule (6 patients, 6 temporal bones). Leukemic infiltration was observed in the petrous apex (13 patients, 24 temporal bones), middle ear (7 patients, 14 temporal bones), cochlea (3 patients, 4 temporal bones), vestibule (3 patients, 4 temporal bones), and internal auditory canal (5 patients, 8 temporal bones). Inflammatory changes were observed in the cochlea (5 patients, 8 temporal bones) and vestibule (5 patients, 8 temporal bones). Middle ear effusion containing floating tumor cells was observed in 4 temporal bones of 3 patients. Irreversible histopathologic changes of the middle ear, such as the destruction of the ossicles, perforation of the tympanic membrane, and granulation tissues were observed in 5 temporal bones of 4 patients.

Conclusions

Ear involvement is common in acute lymphocytic leukemia patients. With prolonged survival due to the progress of treatment, the diagnosis and treatment of nonhematopoietic system symptoms, such as ear problems due to acute lymphocytic leukemia, have become more important.

 

☆ This study was supported by the International Hearing Foundation, the Starkey Foundation, and the Society for Promotion of International Oto-Rhino-Laryngology.

PII: S0196-0709(09)00170-7

doi:10.1016/j.amjoto.2009.08.006

American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 32, Issue 1 , Pages 13-18, January 2011

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