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Updated: May 17, 2026

Endoscopic Cholesteatoma Surgery
08:47

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Comprehensive management of temporal bone defects after oncologic resection.

Matthew M Hanasono1, Amanda K Silva, Peirong Yu

  • 1Department of Plastic Surgery, The University of Texas M D Anderson Cancer Center, Houston, Texas, USA. mhanasono@mdanderson.org

The Laryngoscope
|October 17, 2012
PubMed
Summary

Regional flaps are recommended for smaller temporal bone defects due to shorter operative times and hospital stays. Free flaps are preferred for extensive defects, with facial nerve repair advised when feasible.

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Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Plastic and Reconstructive Surgery

Background:

  • Temporal bone resection for oncologic reasons necessitates complex reconstruction.
  • Choosing the appropriate reconstructive method impacts patient outcomes and recovery.
  • Facial nerve preservation and repair are critical considerations in temporal bone surgery.

Purpose of the Study:

  • To evaluate and compare reconstructive outcomes between regional flaps and microvascular free flaps after oncologic temporal bone resection.
  • To analyze factors influencing facial nerve repair success in this patient population.

Main Methods:

  • Retrospective review of 117 patients undergoing temporal bone resection and reconstruction between 2000 and 2010.
  • Analysis of reconstructive outcomes, including operative time, length of stay, complication rates, and facial nerve repair results.

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  • Assessment of factors affecting facial nerve reinnervation and functional recovery.

    • Main Results:

    • Regional flaps were associated with significantly shorter operative times, ICU stays, and hospital stays compared to free flaps.
    • Overall complication rates were similar between flap types, but free flaps had higher donor site complications.
    • Facial nerve repair in 19 patients showed reinnervation in 71.4% and a House-Brackmann score of 3 or better in 42.9% within 12 months.

    Conclusions:

    • Regional flaps are suitable for smaller defects, offering advantages in operative time and hospital stay.
    • Free flaps are recommended for extensive defects or cases with prior surgery/radiation.
    • Facial nerve repair should be pursued whenever possible, regardless of preoperative nerve status, radiation, or patient age.