Treatment of LCH depends on the site and extent of disease. Curettage and expectant management can be utilized for isolated bony disease (2,4,7). If the lesion is unresponsive or involves a critical site such as the orbit or vertebrae, low-dose radiation has been employed. More extensive lesions generally require systemic chemotherapy. Multiple regimens have been tried, including vincristine, methotrexate, and corticosteroids, with varying degrees of success. Currently, there are no standard treatment regimens for this disorder. Mastoid disease can be managed in several ways. Local otitis externa can respond to aural toilet and topical steroids. Mastoid disease can be treated with mastoidectomy for isolated disease, followed by systemic chemotherapy or radiation therapy if the disease is more problematic or widespread. There are reports of extensive resections for recalcitrant disease (8).
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