title: Chronic ear surgery in irradiated temporal bones.
abstract: OBJECTIVE
  To analyze outcomes of chronic ear surgery in patients with irradiated temporal bones.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Fifteen patients who received radiation involving the temporal bone underwent 21 surgical procedures from 1977 to 1997. Intraoperative findings, long-term complications, and hearing outcomes were analyzed.
  
  
  RESULTS
  Over 50% of cases involved abnormal intraoperative findings including facial nerve dehiscence, labyrinthine fistulas, or dural exposure. Audiologic data revealed that these patients suffered from conductive, mixed, and sensorineural hearing loss. Long-term complications included tympanic membrane perforation and recurrent cholesteatoma. All patients had dry, non-draining ears at the end of the study.
  
  
  CONCLUSIONS
  Irradiated temporal bones present difficult intraoperative anatomy and often require multiple procedures to cure otologic disease. Although radiation significantly reduces vascularity and hampers healing, vascularized reconstruction flaps are not necessary for good outcomes.
authors.affiliation: The Otology Group of Vanderbilt, Department of Otolaryngology, Vanderbilt University, Nashville, TN 37203, USA. marc.bennett@vanderbilt.edu
authors.forename: Marc
authors.initials: M
authors.lastname: Bennett
authors.forename: David
authors.initials: D
authors.lastname: Kaylie
authors.forename: Frank
authors.initials: F
authors.lastname: Warren
authors.forename: C Gary
authors.initials: CG
authors.lastname: Jackson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004427:Ear Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D013506:Otologic Surgical Procedures / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011832:Radiation Injuries / Q000453:epidemiology / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013701:Temporal Bone / Q000528:radiation effects*