Subtotal temporal bone resection for middle ear carcinoma

Abstract

Subtotal temporal bone resection was done for two patients with squamous cell carcinoma of the middle ear. In the first patient, a 68-year-old man, intracranial resection was performed with the resection of the dura mater of middle and posterior cranial fossa, the sigmoid sinus, and total length of auditory tube. In the second patient, a 48-year-old woman, extradural resection was pertormed. Both patients are free of disease over thirty nine months and thirty two months, respectively. From these experiences, key points of this operation are discussed in this paper. Firstly, for wider resection of the tip of petrous bone, release of the carotid artery from the carotid canal is mandatory. It is achieved by drilling the ventral aspect of the carotid canal. Secondly, total resection of the auditory tube including the pharyngeal orifice is mandatory when the tumor extension into the tube is strongly suggested. Thirdly, the significance of the preservation of the lower cranial nerves at the pars nervosa of the jugular foramen, and that of the vein of Labbe are stressed.