Abstract
Objective To evaluate lateral temporal bone resection (LTBR) in the management of advanced
cutaneous squamous cell carcinoma (SCC) with temporal bone invasion and patterns of
failure.
Methods This is a retrospective study of 35 patients undergoing lateral temporal bone resection
for advanced cutaneous SCC at a tertiary care center between 1995 and 2006.
Results The Pittsburgh tumor stage was T4 in 18 patients (51%), T3 in 5 (14%), T2 in 9 (26%),
and T1 in 3 (9%). Clear margins were reported in 22 (63%) patients. Resection of the
mandible and/or temporomandibular joint (TMJ) was required in 11 (31%) patients. Facial
nerve involvement was seen in 10 (29%) patients. Survival outcomes at 2 and 5 years
for overall survival were 72% and 49%; disease-free survival, 68% and 59%; and disease-specific
survival, 79% and 62%, respectively. Pittsburgh T stage correlated significantly with
disease-specific survival (p = 0.015) and margin status was significant for both disease-free survival (p = 0.0015) and disease-specific survival (p < 0.001).
Conclusions Surgery with curative intent is justified for cutaneous SCC invading the temporal
bone with extended LTBR. Margin status was a significant predictor of outcome. Surgeons
should plan preoperatively to achieve clear margins by extending the LTBR with possible
nerve resection.
Keywords
temporal bone - cutaneous malignancy - squamous cell carcinoma - temporal bone resection
