title: Outcomes following temporal bone resection.
abstract: OBJECTIVE
  To evaluate survival outcomes in patients undergoing temporal bone resection.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  From 2002 to 2009 a total of 65 patients underwent temporal bone resection for epithelial (n = 47) and salivary (n = 18) skull base malignancies. Tumor characteristics, defect reconstruction, and postoperative course were assessed. Outcomes measured included disease-free survival and cancer recurrence.
  
  
  RESULTS
  The majority of patients presented with recurrent (65%), advanced stage (94%), cutaneous (72%), and squamous cell carcinoma (57%). Thirty-nine patients had perineural invasion (60%) and required facial nerve resection; 16 (25%) had intracranial extension. Local (n = 6), regional (n = 2), or free flap (n = 46) reconstruction was required in 80% of patients. Free flap donor sites included the anterolateral thigh (31%), radial forearm free flap (19%), rectus (35%), and latissimus (4%). The average hospital stay was 4.9 days (range, 1-28 days). The overall complication rate was 15% and included stroke (n = 4), cerebrospinal fluid leak (n = 2), hematoma formation (n = 1), infection (n = 1), flap loss (n = 1), and postoperative myocardial infarction (n = 1). A total of 22 patients (34%) developed cancer recurrence during the follow-up period (median, 10 months), 17 (77%) of whom presented with recurrent disease at the time of temporal bone resection. Two-year disease-free survival was 68%, and 5-year disease-free survival was 50%.
  
  
  CONCLUSIONS
  Aggressive surgical resection and reconstruction is recommended for primary and recurrent skull base malignancies with acceptable morbidity and improved disease-free survival.
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Nichole R
authors.initials: NR
authors.lastname: Dean
authors.forename: Hilliary N
authors.initials: HN
authors.lastname: White
authors.forename: Dale S
authors.initials: DS
authors.lastname: Carter
authors.forename: Renee A
authors.initials: RA
authors.lastname: Desmond
authors.forename: William R
authors.initials: WR
authors.lastname: Carroll
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: McGrew
authors.forename: Eben L
authors.initials: EL
authors.lastname: Rosenthal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D016019:Survival Analysis; D013701:Temporal Bone / Q000601:surgery*; D016896:Treatment Outcome