SIGNIFICANCE OF TUBAL RESECTION IN SURGICAL-TREATMENT OF MIDDLE-EAR CARCINOMA

We successfully carried out total en bloc resection of squamous cell c arcinoma of the middle ear in two patients. Both patients have been fr ee of the disease for 32-39 months. In one of the cases, the eustachia n tube was resected totally with the temporal bone. Postoperative hist opathological examination proved tumor invasion into the cartilaginous part of the tube. We would like to emphasize the significance of tota l resection of the eustachian tube when neoplastic invasion into the t ube is highly suspected. Axial computed tomography is of great value f or preoperative evaluation of such invasion. Anterior mobilization of the carotid artery from the carotid canal facilitates resection of the petrous apex and should be done after management of the eustachian tu be. The carotid canal is best exposed ventrally, since lateral exposur e is at high risk for injuring the bony part of the eustachian tube an d may possibly disseminate tumor cells.