The oncology of otology

To describe the population of patients with malignancy affecting the ear canal and temporal bone.

Retrospective review.

The charts of 157 patients with temporal bone cancer were reviewed for clinical outcomes.

Between 1999 and 2009, 157 patients underwent temporal bone surgery for cancer involving the ear canal (n = 25), external ear with ear canal involvement (n = 26), periauricular skin (n = 40), parotid gland (n = 40), temporal bone (n = 13), and lateral skull base (n = 13). All surgeries involved one or more otologic approaches: mastoidectomy (28.0%), lateral temporal bone resection (TBR) (59.2%), subtotal TBR (2.5%), total TBR (3.2%), transtemporal approach (TTA) to the jugular foramen (8.2%), TTA to the middle fossa (5.7%), and TTA to the infratemporal fossa (3.2%). Cancers of the cartilaginous ear canal were managed with wide local excision of canal skin and cartilage in nine patients (5.7%). A combination of approaches was performed in 32 patients (20.4%). The 5-year overall survival rate was 58.0%. Patients whose disease was limited to the ear canal had significantly better overall survival than did patients who had skull base primaries (P = .02989), periauricular skin cancer (P = .00138), or temporal bone tumors (P = .02598). Patients with parotid tumors also had better overall survival than did those with periauricular skin tumors (P = .02357).

Otologic surgery plays an important role in managing cancers that involve the ear canal, temporal bone, or lateral skull base. The specialty of otologic oncology is emerging as a defined area of practice.