Skull base surgery for malignant tumor in the temporal bone

Abstract

We introduce here our experience of skull base surgery for temporal bone malignancies and their prognoses. The relationships of their preoperative image study and pathological findings are also estimated prognoses. Twenty-one cases with temporal bone malignancies (carcinoma of the external auditory canal: 20, carcinoma of the middle ear: 1) who underwent radical removal of the tumor were enrolled for this study. These cases were composed of T2: 9, T3: 2 and T4: 10 by the T classification by Kishimoto. According to imaging studies by CT and MRI, 13 lateral petrosectomy and 8 subtotal temporal bone resection were performed. Surgical specimens were histologically diagnosed with negative margins, therefore, these cases had undergone radical surgery. However, 3 of 21 cases showed recurrences and other 18 cases are alive without tumor recurrence. Five year survival rate was 81.1 % by Kaplan-Meier method (6-78 months, median 28 months). These recurrences were mainly observed in the distant area from the surgical site, for example, neck lymph nodes or parapharyngeal spaces. Therefore, a more detailed preoperative image evaluation is put up for future problems.