Temporal Bone Osteoradionecrosis: An 18-year, Single-Institution Experience.

Area of Science:

• Otolaryngology
• Radiation Oncology
• Oncology

Background:

• Temporal bone osteoradionecrosis (TBORN) is a serious complication of radiotherapy.
• Understanding its natural history and prognostic factors is crucial for effective management.

Purpose of the Study:

• To present the largest single-institution review of TBORN.
• To characterize the disease's natural history, prognostic factors, management strategies, and patient outcomes.

Main Methods:

• Retrospective chart review of patients diagnosed with TBORN.
• Descriptive statistics and multivariable analyses were employed to identify risk factors and associations.

Main Results:

• 145 temporal bones in 128 patients were identified with TBORN, with a mean diagnosis age of 62 years, occurring a mean of 10 years post-radiotherapy.
• Older age (>50 years) correlated with earlier diagnosis. Diabetes, 3D-CRT, and periauricular skin malignancy were significant risk factors for diffuse TBORN.
• Localized TBORN responded to conservative management, while diffuse disease often necessitated surgery, especially when extending beyond the mastoid or infratemporal fossa.

Conclusions:

• TBORN incidence and progression are influenced by patient age and specific treatment modalities.
• Identifying prognostic factors aids in developing a staging system and treatment guidelines for improved patient stratification and management.
• Conservative management is suitable for localized TBORN, whereas surgical intervention is frequently required for diffuse disease.