Increased local recurrence in advanced parotid malignancy treated with mastoidectomy without lateral temporal bone...

Area of Science:

• Otolaryngology
• Surgical Oncology
• Head and Neck Cancer Research

Background:

• Advanced parotid malignancy presents challenges in achieving adequate proximal facial nerve exposure.
• Surgical options include mastoidectomy and lateral temporal bone resection, with differing implications for recurrence.

Purpose of the Study:

• To compare local and distant recurrence rates in patients with advanced parotid malignancy undergoing mastoidectomy versus lateral temporal bone resection for facial nerve exposure.

Main Methods:

• A retrospective case series of 120 patients with advanced parotid malignancy treated between 1998 and 2014.
• Patients underwent either parotidectomy with mastoidectomy (no bone involvement) or parotidectomy with lateral temporal bone resection (suspected bone involvement).
• Follow-up ranged from 18 months to 11 years.

Main Results:

• Sixty patients received mastoidectomy and 60 received lateral temporal bone resection.
• Local recurrence was significantly higher in the mastoidectomy group (13/60) compared to the lateral temporal bone resection group (2/60) (p=0.0022).
• No significant difference in distant recurrence was observed between the two groups (p=0.5949).

Conclusions:

• Lateral temporal bone resection is recommended for advanced parotid malignancy, even without overt bone involvement, to minimize local recurrence risk.
• Aggressive surgical management with lateral temporal bone resection offers better local control compared to mastoidectomy alone.