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J Craniomaxillofac Surg. 2018 Oct;46(10):1856-1861. doi: 10.1016/j.jcms.2018.08.002. Epub 2018 Aug 11.

Outcomes of reconstruction after temporal bone resection for malignancy.

Author information

1
Tina and Rick Caruso Department of Otolaryngology and Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address: Caitlin.Bertelsen@med.usc.edu.
2
University of Tel Aviv, Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: Esimsolo@gmail.com.
3
Tina and Rick Caruso Department of Otolaryngology and Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address: Maceri@usc.edu.
4
Tina and Rick Caruso Department of Otolaryngology and Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address: Sinha@med.usc.edu.
5
Tina and Rick Caruso Department of Otolaryngology and Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. Electronic address: Niels.Kokot@med.usc.edu.

Abstract

Reconstruction after temporal bone resection (TBR) is challenging due to the lack of consensus on an optimal approach. Records of the Keck Hospital of USC were searched to identify, collect and group data on patients who underwent TBR for malignancy. Chi-square analysis was used for categorical variables, and ANOVA was used for continuous variables. Forty TBR including 27 lateral (LTBR), 8 total (TTBR), and 5 subtotal (STBR) temporal bone resections were performed at our institution over a ten year time period (2003-2013) and reconstructed with free, regional, and local flaps and tissue grafts. TTBR was associated with postoperative complications as was presence of a dural defect, though other traditionally poor prognostic factors such as age, comorbidity status, and history of irradiation were not. Patients who underwent auriculectomy or parotidectomy were more likely to require free flap reconstruction. We conclude that TBR and reconstruction can be performed successfully on many patients including those who are older or who have more aggressive disease. We recommend free tissue transfer for the large defects created by TTBR, parotidectomy and auriculectomy.

KEYWORDS:

Free tissue flaps; Head and neck cancer; Reconstructive surgery; Skull base neoplasms

PMID:
30170960
DOI:
10.1016/j.jcms.2018.08.002

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