title: The oncology of otology.
abstract: OBJECTIVE
  To describe the population of patients with malignancy affecting the ear canal and temporal bone.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  The charts of 157 patients with temporal bone cancer were reviewed for clinical outcomes.
  
  
  RESULTS
  Between 1999 and 2009, 157 patients underwent temporal bone surgery for cancer involving the ear canal (n = 25), external ear with ear canal involvement (n = 26), periauricular skin (n = 40), parotid gland (n = 40), temporal bone (n = 13), and lateral skull base (n = 13). All surgeries involved one or more otologic approaches: mastoidectomy (28.0%), lateral temporal bone resection (TBR) (59.2%), subtotal TBR (2.5%), total TBR (3.2%), transtemporal approach (TTA) to the jugular foramen (8.2%), TTA to the middle fossa (5.7%), and TTA to the infratemporal fossa (3.2%). Cancers of the cartilaginous ear canal were managed with wide local excision of canal skin and cartilage in nine patients (5.7%). A combination of approaches was performed in 32 patients (20.4%). The 5-year overall survival rate was 58.0%. Patients whose disease was limited to the ear canal had significantly better overall survival than did patients who had skull base primaries (P = .02989), periauricular skin cancer (P = .00138), or temporal bone tumors (P = .02598). Patients with parotid tumors also had better overall survival than did those with periauricular skin tumors (P = .02357).
  
  
  CONCLUSIONS
  Otologic surgery plays an important role in managing cancers that involve the ear canal, temporal bone, or lateral skull base. The specialty of otologic oncology is emerging as a defined area of practice.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. pwgidley@mdanderson.org
authors.forename: Paul W
authors.initials: PW
authors.lastname: Gidley
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Thompson
authors.forename: Dianna B
authors.initials: DB
authors.lastname: Roberts
authors.forename: Franco
authors.initials: F
authors.lastname: DeMonte
authors.forename: Ehab Y
authors.initials: EY
authors.lastname: Hanna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004428:Ear Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010036:Otolaryngology; D013506:Otologic Surgical Procedures / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D019291:Skull Base; D012888:Skull Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D013701:Temporal Bone; D014481:United States / Q000453:epidemiology; D055815:Young Adult