Temporal bone neoplasms: a report on 20 surgically treated cases.

Area of Science:

• Neurosurgery
• Oncology
• Skull Base Surgery

Background:

• Surgical resection of petrous bone neoplasms presents significant challenges due to proximity to critical neurovascular structures.
• Advanced surgical techniques are crucial for managing complex tumors involving the petrous bone, dura, brain, and major vessels.

Observation:

• This study reports on the surgical resection of petrous bone tumors in 20 patients.
• Technical advancements enabled the complete resection of tumors previously deemed inoperable, including those involving the petrous internal carotid artery (ICA), cavernous sinus, and clivus.
• Reconstruction involved the ICA, cranial nerves VII and XI, and the cranial base, often utilizing vascularized flaps.

Findings:

• No intraoperative deaths occurred.
• Temporary morbidity, including wound healing issues and lower cranial nerve palsy, was observed.
• Most patients returned to their preoperative functional status, except for three with fast-growing malignancies.
• Patients with benign or slow-growing tumors had favorable outcomes (7/10 alive and disease-free).
• Patients with fast-growing malignancies had poor outcomes (2/10 alive without disease), correlating with tumor pathology and invasion extent.

Implications:

• Surgical resection is a viable option for petrous bone neoplasms, with outcomes influenced by tumor biology and extent.
• Anatomical classification of tumor spread, alongside pathology, is essential for predicting prognosis.
• Further research into surgical strategies and adjuvant therapies for aggressive petrous bone tumors is warranted.