Outcomes following temporal bone resection.

Academic Article

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.
  • Published In

  • Laryngoscope  Journal
  • Keywords

  • Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Female, Humans, Male, Middle Aged, Retrospective Studies, Skull Base Neoplasms, Surgical Flaps, Survival Analysis, Temporal Bone, Treatment Outcome
  • Digital Object Identifier (doi)

    Authorlist

  • Dean NR; White HN; Carter DS; Desmond RA; Carroll WR; McGrew BM; Rosenthal EL
  • Start Page

  • 1516
  • End Page

  • 1522
  • Volume

  • 120
  • Issue

  • 8