J Neurol Surg B Skull Base 2017; 78(01): 037-042
DOI: 10.1055/s-0036-1584310
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Update on Surgical Outcomes of Lateral Temporal Bone Resection for Ear and Temporal Bone Malignancies

Sumi Sinha
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Matthew M. Dedmon
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Matthew R. Naunheim
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Jennifer C. Fuller
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Stacey T. Gray
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Derrick T. Lin
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

11 April 2016

17 April 2016

Publication Date:
10 June 2016 (online)

Abstract

Objectives Review outcomes of lateral temporal bone resections for ear and temporal bone malignancy.

Design, Setting, and Participants Retrospective review of all lateral temporal bone resections performed from 2008 to 2015 at a single tertiary care center.

Main Outcome Measures Patient demographics, perioperative variables, overall survival, disease-free survival (DFS), and comparison of Kaplan–Meier curves.

Results Overall, 56 patients were identified with a mean follow-up period of 2.3 ± 1.8 years. The predominant histopathologic diagnosis was squamous cell carcinoma (SCC, 54%), followed by salivary gland tumors (18%), and basal cell carcinoma (9%). Tumor stages were T1-T2 in 23%, T3-T4 in 73%, and two unknown primary lesions. Mean overall survival was 4.6 ± 0.4 years. Comparison of tumors with and without lymph node involvement or perineural invasion approached statistical significance for overall survival (p = 0.07 and 0.06, respectively). DFS was 2.5 ± 0.3 years. Stratification by lymph node status had a statistically significant difference in DFS (p = 0.03). Subgroup analysis of SCC patients did not reveal significant differences.

Conclusions Based on our cohort, most patients with temporal bone malignancies present with advanced disease, making it difficult to achieve negative margins. Overall, lymph node status was the strongest predictor of survival in this group.

Financial Disclosures

None.


 
  • References

  • 1 Crabtree JA, Britton BH, Pierce MK. Carcinoma of the external auditory canal. Laryngoscope 1976; 86 (3) 405-415
  • 2 Testa JR, Fukuda Y, Kowalski LP. Prognostic factors in carcinoma of the external auditory canal. Arch Otolaryngol Head Neck Surg 1997; 123 (7) 720-724
  • 3 O'Connor A, Behan L, Toner M, Kinsella J, Beausang E, Timon C. Evaluating the outcomes of temporal bone resection in metastatic cutaneous head and neck malignancies: 13-year review. J Laryngol Otol 2015; 129 (10) 964-969
  • 4 Bacciu A, Clemente IA, Piccirillo E, Ferrari S, Sanna M. Guidelines for treating temporal bone carcinoma based on long-term outcomes. Otol Neurotol 2013; 34 (5) 898-907
  • 5 Parsons H, Lewis JS. Subtotal resection of the temporal bone for cancer of the ear. Cancer 1954; 7 (5) 995-1001
  • 6 Conley JJ, Novack AJ. Surgical treatment of cancer of the ear and temporal bone. Trans Am Acad Ophthalmol Otolaryngol 1960; 64: 83-92
  • 7 Arriaga M, Curtin H, Takahashi H, Hirsch BE, Kamerer DB. Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings. Ann Otol Rhinol Laryngol 1990; 99 (9 Pt 1): 714-721
  • 8 Gaudet JE, Walvekar RR, Arriaga MA , et al. Applicability of the pittsburgh staging system for advanced cutaneous malignancy of the temporal bone. Skull Base 2010; 20 (6) 409-414
  • 9 Xie B, Zhang T, Dai C. Survival outcomes of patients with temporal bone squamous cell carcinoma with different invasion patterns. Head Neck 2015; 37 (2) 188-196
  • 10 Leong SC, Youssef A, Lesser TH. Squamous cell carcinoma of the temporal bone: outcomes of radical surgery and postoperative radiotherapy. Laryngoscope 2013; 123 (10) 2442-2448
  • 11 Essig GF, Kitipornchai L, Adams F , et al. Lateral temporal bone resection in advanced cutaneous squamous cell carcinoma: report of 35 patients. J Neurol Surg B Skull Base 2013; 74 (1) 54-59
  • 12 Moore MG, Deschler DG, McKenna MJ, Varvares MA, Lin DT. Management outcomes following lateral temporal bone resection for ear and temporal bone malignancies. Otolaryngol Head Neck Surg 2007; 137 (6) 893-898
  • 13 Zanoletti E, Lovato A, Stritoni P, Martini A, Mazzoni A, Marioni G. A critical look at persistent problems in the diagnosis, staging and treatment of temporal bone carcinoma. Cancer Treatment Reviews 2015; 41 (10) 821-826
  • 14 Sargi Z, Gerring R, Angeli S , et al. Parotid and temporal bone resection for skull base malignancies: outcome. Skull Base 2010; 20 (3) 169-177