Squamous Carcinoma of the Temporal Bone: Lessons Learned Over the Past Thirty Years

Objective: To review the treatment of squamous carcinoma of the temporal bone at a regional skull base unit for the period 1982–2012.

Methods: A retrospective study of all patients with squamous carcinoma of the temporal bone treated at the Department of Skull Base Surgery (Cambridge, UK) was conducted, with fifty-nine patients identified throughout the 30-year period from 1982 to 2012. Surgical resection and reconstruction, postoperative radiotherapy treatment, follow-up and results are all described.

Results: The five year disease specific survival for the whole cohort was 44% (CI 37–51%). Multivariable analysis revealed nodal status, poorly differentiated squamous cell histology and carotid involvement to be poor prognostic indicators.

Conclusion: Although the survival figures in this series are comparable with the best outcomes from other units, our experience would suggest improvements can still be achieved by reconsidering the selection of patients for neck dissection and temperomandibular joint excision in early stage disease. We also conclude that postoperative radiotherapy should be delivered to all patients, including surgical salvage cases who may have received previous irradiation. Finally, we accept palliative treatment is now required for the minority of cases with the most adverse features.