title: Increased local recurrence in advanced parotid malignancy treated with mastoidectomy without lateral temporal bone resection.
abstract: OBJECTIVE
  We analyzed patients with advanced parotid malignancy requiring proximal facial nerve exposure undergoing mastoidectomy versus lateral temporal bone resection to determine differences in local and distant recurrence.
  
  
  METHODS
  The study design is a case series with chart review.
  
  
  METHODS
  The setting is in Tertiary care practice in Fort Worth, Texas from January1998 to January 2014.
  
  
  METHODS
  The study included 120 patients with advanced parotid malignancy, 82 males between 19 and 87 years, and 38 females between 26 and 83 years. Patients with no overt bone involvement were treated with parotidectomy and mastoidectomy for exposure of the proximal facial nerve, and patients with clinically suspected (radiographic imaging or clinical fixation) bone involvement were treated with parotidectomy and lateral temporal bone resection. Follow up ranged from a minimum of 18 months to 11 years following surgery.
  
  
  RESULTS
  Sixty patients were treated with mastoidectomy and 60 were treated with lateral temporal bone resection. In patients treated with mastoidectomy, 13 had local recurrence and 7 had distal recurrence. In patients treated with lateral temporal bone resection, 2 had local recurrence while 9 had distant recurrence. Statistical analysis revealed that patients treated with mastoidectomy developed local recurrence (p = 0.0022) more commonly than those treated with lateral temporal bone resection. There was no significant difference in distant recurrence between both groups (p = 0.5949).
  
  
  CONCLUSIONS
  Patients with advanced parotid malignancy should be treated aggressively with parotidectomy and lateral temporal bone resection regardless of bone involvement due to increased risk of local recurrence in those treated with mastoidectomy alone.
  
  
  METHODS
  Level of evidence is a 4 case series.
authors.affiliation: Department of Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
authors.forename: Sameep
authors.initials: S
authors.lastname: Kadakia
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Avenue Suite 100, Fort Worth, TX, USA.
authors.forename: David
authors.initials: D
authors.lastname: Chan
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Avenue Suite 100, Fort Worth, TX, USA. yducic@sbcglobal.net.
authors.forename: Yadranko
authors.initials: Y
authors.lastname: Ducic
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Avenue Suite 100, Fort Worth, TX, USA.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cristobal
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Avenue Suite 100, Fort Worth, TX, USA.
authors.forename: Moustafa
authors.initials: M
authors.lastname: Mourad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005154:Facial Nerve / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000074406:Mastoidectomy / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery*; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery*; D012086:Reoperation; D013701:Temporal Bone / Q000601:surgery*
keywords: Facial nerve; Malignancy; Mastoidectomy; Parotid; Temporal bone resection