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 c ause. METHODS AND MATERIAL: Twenty-six cases of temporal bone necrosis were retro spectively reviewed between 1988 and 1997 at the University of British Colu mbia. 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, Patie nts with localized disease of the tympanic bone had minimal symptoms. Those with radiation-induced localized necrosis were less likely to respond to c onservative medical management. Patients with diffuse disease were more lik ely to require surgical intervention. CONCLUSIONS. Temporal bone necrosis comprises a spectrum of disease from id iopathic 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.