title: Inverting papilloma of the temporal bone: case report and meta-analysis of risk factors.
abstract: OBJECTIVE
  To review the literature on inverting papilloma of the middle ear and mastoid with a focus on familiarizing clinicians with its presentation and cause and to discuss its epidemiologic, diagnostic, and therapeutic issues.
  
  
  METHODS
  Search of the English literature for cases of inverted papilloma of temporal bone in conjunction with 1 new case presenting at the UCSD Medical Center.
  
  
  METHODS
  Academic, tertiary referral hospital.
  
  
  METHODS
  The patient underwent radical mastoidectomy with adjuvant therapy, revealing substantial tumor growth filling the external ear canal and middle ear space and obliterating much of the mastoid air cells. Histopathology confirmed inverted papilloma of the middle ear and mastoid. The patient underwent postoperative radiation and has been free of the disease at 6 months of follow-up.
  
  
  RESULTS
  A total of 25 inverted papillomas of the temporal bone cases from the English literature between 1987 and 2010 were reviewed. This tumor commonly presents with hearing loss and otorrhea. Although rare, temporal inverted papillomas display a higher incidence of malignancy (40%) compared with sinonasal papillomas. Secondary and recurrent temporal disease was frequently associated with carcinomatous changes. Although recurrence rate is higher in temporal inverted papillomas than that in sinonasal disease, this difference becomes magnified in cases with more aggressive surgical approaches. We present a case of multicentric inverted papillomas in the middle ear and the sinonasal cavities.
  
  
  CONCLUSIONS
  Efforts to define the cause of middle ear papilloma have been challenging because of its exceeding rarity. Although published literature shows that middle ear papillomas differ from their sinonasal counterparts pathologically and epidemiologically, these papillomas parallel in the unique characteristics of local aggressiveness, tendency to recur, association with malignancy, and multicentricity. Surgical resection with adjuvant radiation therapy and long-term follow-up with magnetic resonance imaging is advocated in the successful management of middle ear inverted papillomas.
authors.affiliation: UCSD School of Medicine, Department of Radiology, La Jolla, California 92093-0647, USA.
authors.forename: Jasper
authors.initials: J
authors.lastname: Shen
authors.forename: Fred
authors.initials: F
authors.lastname: Baik
authors.forename: Mahmood F
authors.initials: MF
authors.lastname: Mafee
authors.forename: Michael
authors.initials: M
authors.lastname: Peterson
authors.forename: Quyen T
authors.initials: QT
authors.lastname: Nguyen
mesh_terms: D004428:Ear Neoplasms / Q000473:pathology* / Q000601:surgery; D004432:Ear, Middle / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D018308:Papilloma, Inverted / Q000473:pathology* / Q000601:surgery; D012307:Risk Factors; D012888:Skull Neoplasms / Q000473:pathology* / Q000601:surgery; D013701:Temporal Bone / Q000473:pathology* / Q000601:surgery