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. 2010 Aug;120(8):1516-22.
doi: 10.1002/lary.20999.

Outcomes following temporal bone resection

Nichole R Dean  1 , Hilliary N White, Dale S Carter, Renee A Desmond, William R Carroll, Benjamin M McGrew, Eben L Rosenthal
Affiliations

Outcomes following temporal bone resection

Nichole R Dean et al. Laryngoscope. 2010 Aug.

Abstract

Objectives/hypothesis: To evaluate survival outcomes in patients undergoing temporal bone resection.

Study design: Retrospective review.

Methods: From 2002 to 2009 a total of 65 patients underwent temporal bone resection for epithelial (n = 47) and salivary (n = 18) skull base malignancies. Tumor characteristics, defect reconstruction, and postoperative course were assessed. Outcomes measured included disease-free survival and cancer recurrence.

Results: The majority of patients presented with recurrent (65%), advanced stage (94%), cutaneous (72%), and squamous cell carcinoma (57%). Thirty-nine patients had perineural invasion (60%) and required facial nerve resection; 16 (25%) had intracranial extension. Local (n = 6), regional (n = 2), or free flap (n = 46) reconstruction was required in 80% of patients. Free flap donor sites included the anterolateral thigh (31%), radial forearm free flap (19%), rectus (35%), and latissimus (4%). The average hospital stay was 4.9 days (range, 1-28 days). The overall complication rate was 15% and included stroke (n = 4), cerebrospinal fluid leak (n = 2), hematoma formation (n = 1), infection (n = 1), flap loss (n = 1), and postoperative myocardial infarction (n = 1). A total of 22 patients (34%) developed cancer recurrence during the follow-up period (median, 10 months), 17 (77%) of whom presented with recurrent disease at the time of temporal bone resection. Two-year disease-free survival was 68%, and 5-year disease-free survival was 50%.

Conclusions: Aggressive surgical resection and reconstruction is recommended for primary and recurrent skull base malignancies with acceptable morbidity and improved disease-free survival.

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Conflict of interest statement

The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
(A) Class I defect following reconstruction with an anterolateral thigh (ALT) flap and preservation of the auricle. (B) Class II defect with partial auriculectomy and free flap reconstruction. (C) Class III defect in which the patient has had a complete auriculectomy and middle ear obliteration following lateral temporal bone resection.
Fig. 2
Fig. 2
Five-year disease-free survival for patients with lateral temporal bone malignancies.
Fig. 3
Fig. 3
Disease-free survival for recurrent versus primary disease.
Fig. 4
Fig. 4
Disease-free survival by class defect.
See this image and copyright information in PMC

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