J Neurol Surg B
DOI: 10.1055/s-0039-1696723
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Management of Temporal Bone Malignancy in Ireland

Robbie S. R. Woods
1  Department of Otolaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
,
Anel Naude
1  Department of Otolaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
,
John Barry O'Sullivan
2  Department of Plastic Surgery, Beaumont Hospital, Dublin, Ireland
,
Daniel Rawluk
3  Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland
,
Mohsen Javadpour
3  Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland
,
Peter Walshe
1  Department of Otolaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
,
Peter D. Lacy
1  Department of Otolaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
,
James Paul O'Neill
1  Department of Otolaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
,
Rory McConn-Walsh
1  Department of Otolaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
› Author Affiliations
Funding No funding was received for this research.
Further Information

Publication History

20 April 2019

28 July 2019

Publication Date:
29 August 2019 (online)

Abstract

Objectives Lateral temporal bone malignancy remains a challenging rare disease. We report 17 years of multidisciplinary care of these tumors with univariate and multivariate analyses of key prognostic indicators for consideration in contemporary oncological management.

Design This is a retrospective cohort study.

Setting This is set at a tertiary referral center.

Participants All patients presenting with histopathologically newly diagnosed cases of temporal bone malignancy between 2000 and 2017 were included.

Main Outcome Measures The main outcome measures are disease-specific and recurrence-free survival rates.

Results In this study, 48 cases of temporal bone malignancy were diagnosed. Median age at diagnosis was 69 years (range: 5–88). Fourteen patients were female. Squamous cell carcinoma was the predominant malignancy in 34 cases (71%). Surgical treatment was undertaken in 37 patients. Mean length of follow-up was 32 months (range: 0.7–117). Overall 5-year disease-specific survival was 52.4%, while overall 5-year recurrence-free survival was 53.5%. On univariate analysis, significantly worse survival was seen in females (p = 0.008), those with distant metastatic disease (p = 0.041), and in middle ear involvement (p = 0.012) with no difference for involvement of the external auditory canal (p = 0.98) or mastoid (p = 0.78). Only middle ear involvement remained significant on multivariate analysis.

Conclusion A wide variety of malignant pathology may present in the temporal bone. Recurrence-free survival is equivalent to international data; however, this figure is low. This emphasizes the need to treat these tumors appropriately with radical resection, where possible, at first presentation. Therefore, multidisciplinary surgical input is recommended. Middle ear involvement was a negative prognosticator for disease-specific and recurrence-free survivals.

Note

Data from this article were presented at the British Skull Base Society Meeting, Liverpool, England on January 26, 2018, and 6th World Congress of the International Federation of Head and Neck Oncologic Societies, Buenos Aires, September 4, 2018.