Outcomes following temporal bone resection

✍ Scribed by Nichole R. Dean; Hilliary N. White; Dale S. Carter; Renee A. Desmond; William R. Carroll; Benjamin M. McGrew; Eben L. Rosenthal

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 570 KB
• Volume: 120
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.20999

✦ Synopsis

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. Laryngoscope, 2010