Anatomic Consideration of the Medial Cuts for Lateral Temporal Bone Resection: Cadaveric Study

Two widely used en bloc resection techniques for external auditory canal malignancies are lateral temporal bone resection (LTBR) and subtotal temporal bone resection (STBR). STBR is a surgical procedure that requires a skull base team, whereas LTBR is a widely practiced procedure worldwide that can be completed as an otological procedure. In LTBR, the external auditory canal is removed en bloc with basic otological techniques, including mastoidectomy and extended posterior tympanotomy. However, detailed descriptions of the osteotomy technique for the anterior deep portion of the external auditory canal are scarce. The authors examined the most challenging site for separation in LTBR using 11 cadaveric specimens. The average 3.8 mm length of bone just anteroinferior to the tympanic membrane tends to be left disconnected. Thus, it is necessary to appropriately separate this area according to its anatomic variations to achieve a complete en bloc resection with negative margins.