Temporal bone resection for lateral skull-base malignancies
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TOPIC REVIEW
Temporal bone resection for lateral skull‑base malignancies Gautam U. Mehta1 · Thomas J. Muelleman2 · Derald E. Brackmann2 · Paul W. Gidley3 Received: 13 January 2020 / Accepted: 25 February 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Malignancies involving the temporal bone are increasingly common and require specialized multi-disciplinary care. Given this complex location, involvement of the lateral skull base and local neurovascular structures is common. In this review we discuss general principles for temporal bone resection, as well as alternative and complementary surgical approaches that should be considered in the management of patients with temporal bone cancer. Methods A comprehensive review on literature pertaining to temporal bone resection was performed. Results The primary surgical strategy for malignancies of the temporal bone is temporal bone resection. This may be limited to the ear canal and tympanic membrane (lateral temporal bone resection) or may include the otic capsule and its contents (subtotal temporal bone resection), and/or the petrous apex (total temporal bone resection). Management of adjacent neurovascular structures including the facial nerve, the carotid artery, and the jugular bulb/sigmoid sinus should be considered during surgical planning. Finally, adjunctive procedures such as parotidectomy and neck dissection may be required based on tumor stage. Conclusions Temporal bone resection is an important technique in the treatment of lateral skull-base malignancies. This strategy should be incorporated into a multi-disciplinary approach to cancer. Keywords Facial nerve · Lateral skull base · Malignancy · Temporal bone resection
Introduction Malignancies such as non-melanomatous skin cancer involving the head and neck are increasingly common [1]. Such malignancies specifically involving the temporal bone may arise from the parotid gland or from the skin of the auricle or external auditory canal (EAC). Among these, the most common histologies include squamous cell carcinoma (> 40%), basal cell carcinoma (10–15%), adenoid cystic carcinoma (8–10%) and melanoma (
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