Temporal bone resection

It must be emphasized that the greatest impact of survival can only be obtained through an early diagnosis and a radical treatment program. Any granulation tissue must be sent for biopsy to rule out the possibility of malignancy in the setting of chronic otitis media. Once carcinoma is diagnosed, imaging studies must be obtained to define the extent of the tumor. Under diagnosis is the rule with these malignancies. Tumors limited to the external auditory canal can be adequately resected with a lateral temporal bone resection. Extension into the middle ear and mastoid aircell systems requires either a subtotal temporal bone resection or a lateral temporal bone resection with a radical mastoidectomy and petrousectomy. The inclusion of the petrous apex with the resection, as in a temporal bone resection, does not add to survival but increases morbidity. Radical postoperative radiation therapy is essential for maximum local control and survival with these malignancies.