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Michael J. Cunningham, MD; Hugh D. Curtin, MD; Ronald Jaffe, MB, BCh; Sylvan E. Stool, MD

Arch Otolaryngol Head Neck Surg. 1989;115(7):807-813.

Abstract
• Eighteen of 62 children diagnosed with Langerhans' cell histiocytosis at the Children's Hospital of Pittsburgh (Pa) between 1970 and 1986 demonstrated ear and temporal bone involvement. In six children, such otologic disease was their sole presenting manifestation. Common signs and symptoms included aural discharge, postauricular swelling, and conductive hearing loss. The otologic findings in these children, if not investigated properly, could easily be attributed to acute or chronic infectious ear disease. Computed tomography with contrast enhancement proved to be particularly valuable as a diagnostic study because of its clear delineation of both osseous and soft-tissue temporal bone involvement. Computed tomographic findings could also be used to enhance local treatment by guiding surgical biopsy and curettage procedures or defining low-dose radiation therapy portals. Eleven of these 18 children with otologic Langerhans' cell histiocytosis additionally required chemotherapy due to the systemic nature of their disease.

(Arch Otolaryngol Head Neck Surg. 1989;115:807-813)

Author Affiliations
From the Departments of Otolaryngology (Drs Cunningham and Stool), Radiology (Dr Curtin), and Pathology (Dr Jaffe), University of Pittsburgh (Pa) Eye and Ear and Children's Hospitals. Dr Cunningham is now with the Massachusetts Eye and Ear Infirmary, Boston, Mass.

Footnotes
Accepted for publication January 13, 1989.

Presented at the 15th annual meeting of the Society for Ear, Nose, and Throat Advances in Children, Denver, Colo, December 6, 1987.

Reprint requests to Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114 (Dr Cunningham).

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