Outcomes of reconstruction after temporal bone resection for malignancy

Area of Science:

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

Background:

• Reconstruction following temporal bone resection (TBR) lacks a standardized approach.
• Malignancy is a common indication for TBR, necessitating complex surgical management.
• Optimal reconstructive techniques require further investigation to improve patient outcomes.

Purpose of the Study:

• To analyze outcomes of various reconstruction methods after temporal bone resection (TBR).
• To identify factors associated with postoperative complications in TBR patients.
• To evaluate the success of different flap and graft techniques in TBR reconstruction.

Main Methods:

• Retrospective review of 40 TBR cases (lateral, subtotal, total) at Keck Hospital of USC (2003-2013).
• Data collected on patient demographics, surgical extent, reconstruction type (free, regional, local flaps, tissue grafts), and postoperative complications.
• Statistical analysis included Chi-square for categorical and ANOVA for continuous variables.

Main Results:

• Total TBR and the presence of a dural defect were significantly associated with postoperative complications.
• Age, comorbidity, and prior irradiation did not predict poorer outcomes.
• Auriculectomy or parotidectomy increased the likelihood of requiring free flap reconstruction.

Conclusions:

• Temporal bone resection and reconstruction are feasible and successful, even in older patients or those with aggressive disease.
• Free tissue transfer is recommended for managing large defects resulting from total TBR, parotidectomy, and auriculectomy.
• Further research into optimizing reconstructive strategies for TBR is warranted.