Gautam U Mehta1, Thomas J Muelleman2, Derald E Brackmann2, Paul W Gidley3. 1. Division of Neurosurgery, House Institute, 2100 West 3rd Street, Ste 111, Los Angeles, CA, USA. gmehta39@gmail.com. 2. Division of Neurotology, House Institute, Los Angeles, CA, USA. 3. Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Abstract
INTRODUCTION: Malignancies involving the temporal bone are increasingly common and require specialized multi-disciplinary care. Given this complex location, involvement of the lateral skull base and local neurovascular structures is common. In this review we discuss general principles for temporal bone resection, as well as alternative and complementary surgical approaches that should be considered in the management of patients with temporal bone cancer. METHODS: A comprehensive review on literature pertaining to temporal bone resection was performed. RESULTS: The primary surgical strategy for malignancies of the temporal bone is temporal bone resection. This may be limited to the ear canal and tympanic membrane (lateral temporal bone resection) or may include the otic capsule and its contents (subtotal temporal bone resection), and/or the petrous apex (total temporal bone resection). Management of adjacent neurovascular structures including the facial nerve, the carotid artery, and the jugular bulb/sigmoid sinus should be considered during surgical planning. Finally, adjunctive procedures such as parotidectomy and neck dissection may be required based on tumor stage. CONCLUSIONS: Temporal bone resection is an important technique in the treatment of lateral skull-base malignancies. This strategy should be incorporated into a multi-disciplinary approach to cancer.
INTRODUCTION:Malignancies involving the temporal bone are increasingly common and require specialized multi-disciplinary care. Given this complex location, involvement of the lateral skull base and local neurovascular structures is common. In this review we discuss general principles for temporal bone resection, as well as alternative and complementary surgical approaches that should be considered in the management of patients with temporal bone cancer. METHODS: A comprehensive review on literature pertaining to temporal bone resection was performed. RESULTS: The primary surgical strategy for malignancies of the temporal bone is temporal bone resection. This may be limited to the ear canal and tympanic membrane (lateral temporal bone resection) or may include the otic capsule and its contents (subtotal temporal bone resection), and/or the petrous apex (total temporal bone resection). Management of adjacent neurovascular structures including the facial nerve, the carotid artery, and the jugular bulb/sigmoid sinus should be considered during surgical planning. Finally, adjunctive procedures such as parotidectomy and neck dissection may be required based on tumor stage. CONCLUSIONS: Temporal bone resection is an important technique in the treatment of lateral skull-base malignancies. This strategy should be incorporated into a multi-disciplinary approach to cancer.
Entities:
Keywords:
Facial nerve; Lateral skull base; Malignancy; Temporal bone resection
Authors: Paul W Gidley; Christopher R Thompson; Dianna B Roberts; Franco DeMonte; Ehab Y Hanna Journal: Laryngoscope Date: 2012-01-17 Impact factor: 3.325