Skull Base Surgery of the Temporal Bone

Abstract

Objectives: The aim of this study was to review major temporal bone cases performed by one surgeon, and to highlight pitfalls and progress in the surgical management of previously unresectable neoplasms. Design: Retrospective case series review. Setting: Tertiary referral center. Participants: Nine patients who underwent total en bloc temporal bone resection for malignancy of the ear and temporal bone. Main Outcome Measures: Histories, surgical techniques, postoperative complications and outcomes, and changes in the approach to total en bloc resection of the temporal bone were analyzed. Results: With combinations of extensive surgery, radiation therapy, and chemotherapy, some patients with aggressive skull base neoplasms once deemed unresectable survive and appear free of disease. Total en bloc temporal bone resection was developed over 25 years ago. Additional experience has led to significant modifications in the technique, some of which have not been published previously. Conclusion: The morbidity and mortality associated with malignancy of the temporal bone may justify extensive surgery. In the hands of an experienced skull base team, total temporal bone resection can be performed successfully. This approach offers hope for survival in some patients with malignancy of the temporal bone.