Petrosectomy and Radiation in Carcinoid Tumors of the Temporal Bone

Objective: Report outcomes of surgery and radiation in patients with high-risk carcinoid tumors of the temporal bone. Study Design: Case series. Patients/material and Methods: Two patients with temporal bone carcinoid and solid tumor histology and nerve invasion. Results: Carcinoids arising in the temporal bone are rare. Although often reported as neuroendocrine adenoma of the middle ear (NAME), suggesting benign pathology, our previous work established that fluctuating facial nerve dysfunction that precedes diagnosis and predominantly solid tumor histology are negative prognostic factors in patients with this diagnosis. We report the outcomes of 2 of 11 patients in our series with poor prognostic indicators who underwent subtotal petrosectomy and postoperative radiation. Both patients developed distant metastasis despite labyrinthine and facial nerve sacrifice followed by 12 Gy of focused radiation within 2 years of treatment. Conclusions: Patients with temporal bone carcinoids with solid histology and facial nerve invasion may benefit from earlier and more radical surgery followed by full-course radiation therapy to reduce the risk of metastasis.