Primary carcinoma involving the temporal bone: analysis of twenty-five cases

Twenty-five patients with primary carcinoma involving the temporal bone were reviewed. Pain and discharge were the most common complaints. A history of previous otitis media was found in 64% of the patients. On clinical and radiological assessment, 18 cases were deemed surgically resectable and 7 unresectable. Analysis of treatment revealed 3 groups of patients: an unresectable group of 7 patients treated by primary radical radiation therapy in which there were no long-term survivors; another group received primary radiotherapy with surgery reserved for residual or recurrent disease--4 of this group of 12 survived 4 years or longer; and the remaining group had primary surgery with radical postoperative radiation therapy--4 of this group of 6 patients survived 4 years or longer despite incomplete surgical removal of tumor in all except 1 patient. The results and possible reasons for failure are discussed.