Temporal bone and lateral skull base malignancy: Experience and results with 81 patients

Objective: This study aimed to examine predictive factors and treatment out come and to devise a staging method for malignant lateral skull base diseas e. Study Design: The study design was a retrospective review of all lateral sk ull base surgery cases. Setting: The study was conducted at a tertiary referral center. Patients: Of 317 lateral skull base lesions, 81 patients were found to have malignant disease. Three groups were identified, and the data were analyze d according to the following: epithelial malignancies, 30 patients; maligna ncies of salivary gland origin, 23 patients; and malignancies of mesenchyma l origin, 28 patients. The mean age was 48.5 years with a range of 5-83 yea rs. There were 42 males and 39 females. Our mean followup time was 54 month s with a range of 1-180 months. Forty-three patients were alive without evi dence of recurrent disease, 6 were living with disease, 25 were dead of dis ease, 3 died of other causes, and 4 were lost to follow-up, Interventions: All patients underwent surgery with curative intent. Forty-t wo received adjuvant radiation, and 8 received chemotherapy. Main Outcome Measures: Treatment failure, survival, cranial nerve deficits, complications, and predictive factors were analyzed. Results: A 58% treatment success rate was observed. Epithelial and salivary malignancy had a poorer prognosis, and pain and facial nerve dysfunction a t presentation carried a worse prognosis. Conclusions: Lateral skull base malignancy is a rare entity that continues to challenge cranial base surgeons. Cranial nerve deficits and complication s are frequent. The success rate of treatment is dependent on histology and disease extent.