Long-Term Outcomes of Temporal Bone Aneurysmal Bone Cysts: Ambispective Study With Systematic Review and Pooled Analysis

Objective: To analyse the clinical, radiological, and surgical management of temporal bone aneurysmal bone cysts (ABCs) and identify factors affecting outcomes.

Study design: Ambispective study.

Setting: A single tertiary care institution.

Methods: This study reviewed 6 cases of temporal bone ABCs treated between 2017 and 2024. Patient demographics, clinical presentation, imaging characteristics, surgical details, and outcomes were collected. A systematic review of the literature was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, to compare institutional cases with published data. Statistical analyses were performed to identify predictors of treatment success and recurrence.

Results: The cohort had a mean age of 27.5 years. Presenting symptoms included scalp swelling, aural fullness, tinnitus, and hearing impairment. Imaging showed expansile lesions with fluid-fluid levels and bone erosion. All patients underwent gross total excision, with a mean intraoperative blood loss of 230.6 ml. One patient experienced temporary grade III facial palsy, which resolved within 3 months. No recurrences were observed during a mean follow-up of 35 months. A pooled analysis of 45 cases from the literature revealed that swelling in the temporal region was the most common presenting feature, and gross total resection was the most frequently employed treatment. Recurrences were rare and typically associated with subtotal resections or advanced-stage tumors.

Conclusion: Surgical excision, particularly gross total resection, is the treatment of choice for temporal bone ABCs, with a low recurrence rate. Stage and extent of resection are critical factors in predicting outcomes. This study enhances understanding of the diagnostic and therapeutic approaches for this rare condition.