Parotid and temporal bone resection for skull base malignancies: outcome

We reviewed the outcome of and determined prognostic factors for patients undergoing combined lateral skull base resection for advanced lateral skull base malignancies. We performed a retrospective, single-institution case series in an academic tertiary care hospital. Seventy-nine patients with combined temporal bone resection and parotidectomy for advanced lateral skull base malignancy were included. Main outcome measures were overall survival and disease-free survival. The mean follow-up time was 18.3 months, with an overall survival of 64.5 months and disease-free survival of 42.6 months. Disease-free survival was 36.2 months for skin tumors, 42.7 months for salivary glands tumors, and 8.5 months for tumors of mesenchymal origin. Log-rank tests for prognostic indicators demonstrated that temporal bone erosion on computed tomography (CT) scan (p = 0.009) and histology (p = 0.045) were statistically significant predictors of poor outcome. Subtotal resection of the facial nerve and positive lymph nodes were associated with poor outcome in tumors arising from skin. Advanced malignancies of the lateral skull base are best managed using a combined lateral temporal bone resection and parotidectomy, with a 50% disease-specific survival of 32 months. Malignant mesenchymal tumors as well as presence of temporal bone erosion on preoperative CT scan are associated with poor prognosis.