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Temporal bone management in external and middle ear carcinoma
Shravan Gowrishankar1, Daniele Borsetto1, John Marinelli2
1Department of Otolaryngology - Head & Neck Surgery, Cambridge University Hospitals NHS Trust.
Current Opinion in Otolaryngology & Head and Neck Surgery
|January 9, 2024
Summary
Management of external and middle ear carcinoma involves surgical resection, with options ranging from lateral to total temporal bone resection based on tumor stage. Advances in immunotherapy, like anti-PD-1 inhibitors, show promise, but further trials are needed.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Medical Oncology
Background:
- External and middle ear carcinoma presents complex management challenges.
- Temporal bone resection is the primary treatment modality.
- Auditory rehabilitation and immunotherapy are evolving treatment adjuncts.
Approach:
- Review of current evidence for surgical staging and resection techniques.
- Evaluation of advancements in auditory rehabilitation options.
- Analysis of emerging immunotherapy strategies, including anti-PD-1 monoclonal antibodies.
Key Points:
- Surgical approaches vary from lateral to subtotal and total temporal bone resection, guided by the Pittsburgh staging tool.
- Parotidectomy and neck dissection may be necessary for advanced disease.
- Auditory rehabilitation options include osseointegrated hearing aids and active middle ear implants.
- Anti-PD-1 inhibitors represent a promising advancement in immunotherapy for temporal bone cancers.
Conclusions:
- Surgical resection remains the cornerstone for temporal bone carcinoma.
- Treatment selection depends on tumor stage and extent.
- Immunotherapy, particularly anti-PD-1 inhibitors, shows potential but requires further clinical validation, especially in combination with surgery.
