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The Egyptian Journal of Otolaryngology
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Temporal bone resection for patients with head and neck cancer: surgical modalities and techniques of reconstruction

The Egyptian Journal of Otolaryngology volume 33, pages 579–587 (2017)Cite this article

Abstract

Objective

The aim of this article is to present authors’ experience of using different modalities of temporal bone resection (TBR) and methods of reconstruction in malignant tumor involving temporal bone.

Patients and methods

For 27 patients scheduled for TBR, computed tomography was done for all patients, whereas complementary MRI for 13 patients. Different indications, TBR types, reconstruction technique, complications, and outcome were documented and analyzed.

Results

This study included 27 patients who had malignancy of or extend to temporal bone, including 11 (40.7%) external auditory canal, eight (29.6%) parotid gland, seven (26%) middle ears, and one (3.7%) lateral skull base tumors. The mean age of the patients was 57±10.4 years. Final histopathology was proved to be squamous cell carcinoma in 15 patients, adenoid cystic carcinoma in eight patients, and adenocarcinoma in four patients. Types of TBR were Lewis en-block technique in seven (26%) cases, lateral TBR in eight (29.6%) cases, modified lateral TBR in eight (29.6%) cases, and subtotal TBR in four cases (14.8%).

Neck dissection (ND) was performed in all patients in the form of modified radical neck dissection (13 cases), radical neck dissection (five cases), supraomohyoid (three cases), and upper neck dissection (six cases).

All preoperative clinicoradiological staging was upstaged postoperatively. Reconstruction of resulting defects was done using temporalis muscle flap (55.5%), pectoralis major myocutaneous flap (26%), latissimus dorsi myocutaneous flap (3.7%), trapezius myocutaneous flap (3.7%), and free flaps (14.8%). Reported complications were dural tears (22.2%), internal jugular vein injury (3.7%), transient vertigo (55.5%), complete facial nerve paralysis (33.3%), and hearing loss (14.8%). Postoperative adjuvant radiotherapy was given to 17 (62.9%) patients. The overall 3-year survival was 73%.

Conclusion

Commonest temporal bone involving malignancy was squamous cell carcinoma. TBR is integral part of radical resection for certain cancers involving temporal bone. Postoperative radiotherapy is usually needed. Operative tumor staging is more advanced than preoperative.

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Author information

Authors and Affiliations

  1. Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

    Ayman Amin, Sherif Zayed & Mahmoud Bassiouny

  2. Department of Otolaryngology, Faculty of Medicine, Al Azhar University, Cairo, Egypt

    Ibrahim El-Dessouky & Mohammed Shams El-Din

  3. Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Abdel-Raouf Said & Mohammad W. El-Anwar (MD)

Authors
  1. Ayman Amin
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  2. Sherif Zayed
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  3. Ibrahim El-Dessouky
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  4. Abdel-Raouf Said
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  5. Mohammed Shams El-Din
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  6. Mohammad W. El-Anwar
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  7. Mahmoud Bassiouny
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Corresponding author

Correspondence to Mohammad W. El-Anwar.

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Amin, A., Zayed, S., El-Dessouky, I. et al. Temporal bone resection for patients with head and neck cancer: surgical modalities and techniques of reconstruction. Egypt J Otolaryngol 33, 579–587 (2017). https://doi.org/10.4103/ejo.ejo_80_16

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  • DOI: https://doi.org/10.4103/ejo.ejo_80_16

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