EXTENDED TEMPORAL BONE RESECTION FOR SQUAMOUS-CELL CARCINOMA

OBJECTIVE: The aim of this study was to assess the surgical results of a series of patients from this unit who underwent extended temporal b one resection for recurrent squamous cell carcinoma as a salvage proce dure. DESIGN: The surgical records of 15 patients were analyzed in det ail, Each patient had salvage surgery in the form of an extended tempo ral bone resection with supraomohyoid block dissection, dural grafting , and free microvascular forearm or scalp rotation flap repair for rec urrent squamous cell carcinoma in a radical mastoid cavity. RESULTS: R adical surgery yielded a 47% 5-year survival, Twenty-nine percent of t he survivors had temporal lobe involvement that necessitated a partial excision of the temporal lobe of the brain, Histologic evidence of lo cal lymph nods involvement in the supraomohyoid neck dissection was pr esent in 13% of cases. Those who died did so in the first postoperativ e year. All those with poorly differentiated tumors died, The survivor s had well or moderately differentiated tumors. CONCLUSIONS: Radiother apy alone or partial temporal bone resection, most commonly a radical mastoidectomy with or without preoperative or postoperative radiothera py is used by the majority of otolaryngologists in treating squamous c ell carcinoma of the temporal bone, The 5-year survival rate after thi s treatment remains depressingly low and the prognosis gloomy, particu larly for advanced tumors, The findings in this series of extended tem poral bone resections as salvage surgery in recurrent disease is encou raging, and radical surgery combined with radiotherapy from the outset may give much better 5-year survival figures in the future than the c onventional partial temporal bone resection and radiotherapy.