title: Lateral temporal bone and parotid malignancy with facial nerve involvement.
abstract: OBJECTIVE
  To review our institution's experience and outcomes in the treatment of lateral temporal bone (LTB) and parotid malignancy with facial nerve (FN) involvement. To identify risk factors for treatment failures and to clarify previously established prognostic factors for this advanced-stage disease.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary care academic hospital.
  
  
  METHODS
  A series of 26 patients treated operatively for malignancy of the LTB and parotid gland with FN involvement were reviewed retrospectively. All patients underwent sacrifice of the FN due to intraoperative determination of nerve invasion. Demographic, historical, intraoperative, pathologic, and follow-up data were collected and analyzed to determine survival outcomes and locoregional control. Risk factor analysis was performed.
  
  
  RESULTS
  The FN was found to be grossly involved by tumor at the stylomastoid foramen in 57.7% of patients, resulting in sacrifice more proximally in the vertical segment in 57.7%. Statistical analysis demonstrated a locoregional recurrence rate of 34.6%, with the majority of recurrence occurring within the first 2 years after surgery. The rate of distant failure was 15.4%. Kaplan-Meier and chi-square analysis showed an overall survival of 76.0%, 66.7%, 35.3%, 31.2%, and 28.6% at 1, 2, 3, 4, and 5 years, respectively. Advanced age, the presence of tumor of epithelial origin, and pathologically positive lymph nodes are significantly predictive of poor survival.
  
  
  CONCLUSIONS
  Outcomes of malignancy of the LTB with FN involvement treated with primary surgical therapy compare favorably with previously published control rates, and overall prognosis for this condition is likely better than historically established.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loyola University of Chicago Stritch School of Medicine, Maywood, IL 60153, USA.
authors.forename: Avinash V
authors.initials: AV
authors.lastname: Mantravadi
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Marzo
authors.forename: John P
authors.initials: JP
authors.lastname: Leonetti
authors.forename: Keith N
authors.initials: KN
authors.lastname: Fargo
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Carter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005154:Facial Nerve / Q000473:pathology*; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010307:Parotid Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012888:Skull Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D013701:Temporal Bone / Q000601:surgery; D055815:Young Adult