Temporal bone necrosis: diagnosis, classification, and management.

OBJECTIVE: The goal of this study was to analyze temporal bone necrosis and classify its diagnosis and treatment according to extent of necrosis and cause. METHODS AND MATERIAL: Twenty-six cases of temporal bone necrosis were retrospectively reviewed between 1988 and 1997 at the University of British Columbia.
RESULTS: Patients were classified on the basis of disease extent restricted to the tympanic bone or extension beyond the tympanic bone, as well as on the basis of the cause of disease; treatment based on classification. Patients with localized disease of the tympanic bone had minimal symptoms. Those with radiation-induced localized necrosis were less likely to respond to conservative medical management. Patients with diffuse disease were more likely to require surgical intervention.
CONCLUSIONS: Temporal bone necrosis comprises a spectrum of disease from idiopathic tympanic bone necrosis, which rarely requires surgery, to the more severe forms of radiation-induced diffuse temporal bone necrosis that may cause life-threatening complications requiring surgical intervention.