Efficacy of petrosectomy in malignant invasion of the temporal bone

We present the outcomes of lateral, subtotal, and total petrosectomies in patients with invasion of the temporal bone by specific primary cancers, with particular emphasis on survival in the advanced stages of disease. We made a retrospective study of 20 consecutive patients (squamous cell carcinoma of the temporal bone, n=11, and primary cancer of the parotid gland with infiltration of the lateral skull base, n=9) treated by total, subtotal, or lateral petrosectomy at the University Department of Otolaryngology, a tertiary referral centre, between June 2006 and December 2010. Fourteen of the 20 patients were alive at the time of analysis, and follow-up ranged from 36-60 months. Six of seven patients whose disease relapsed (4 local and 3 distant metastases) died. The three-year, disease-free survival was 65% and the overall survival 68%. Survival between those with temporal bone and parotid tumours did not differ significantly. The combined group survival was affected by involvement of invaded resection margins (n=6, p=0.03). Involved margins were significant in the development of recurrence (p=0.03). Tumour stage, nodal involvement, type of operation, sex, age, skin involvement, facial palsy, and previous history of disease had no impact on prognosis. There was a significant difference in the survival curves of patients with carcinoma of the temporal bone with and without facial paresis (n=6 compared with n=5; p=0.046). Two of 11 free flaps required revision of the anastomoses, but none was lost.