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Lateral temporal bone resection for extensive pinnal malignancy. Has anything changed in forty years?
J C Shotton1, R J Sergeant, N S Tanner
1Department of Otolaryngology, Kent and Sussex Hospital, Tunbridge Wells.
The Journal of Laryngology and Otology
|August 1, 1993
Summary
This study evaluated a modified surgical technique for advanced external ear tumors, including microsurgical dissection. While outcomes showed limited improvement in survival rates, the intervention remains valuable for potential cure and symptom relief.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Advanced external ear tumors present significant surgical challenges.
- Traditional excision methods may have limitations in achieving complete tumor removal.
- A modified microsurgical approach was developed to address these challenges.
Purpose of the Study:
- To describe and evaluate a contemporary surgical approach for advanced external ear tumors.
- To assess the efficacy and outcomes of this modified technique in a series of patients.
- To compare current results with historical data on the management of these tumors.
Main Methods:
- A series of 11 patients with advanced external ear tumors (squamous cell carcinoma, basal cell carcinoma, mucoepidermoid carcinoma) were treated.
- A modified excision involved microsurgical dissection of the lateral temporal bone, en bloc with soft tissues.
- Reconstruction utilized scalp or myocutaneous flaps.
Main Results:
- Actuarial survival was 36%, with a 54% disease clearance rate.
- Four patients (36%) were alive with no evidence of disease at a mean of 4.2 years.
- Three patients (27%) died from recurrent disease, and two (18%) experienced post-operative deaths.
Conclusions:
- The contemporary surgical approach, while utilizing microsurgical techniques, has not dramatically improved survival for advanced external ear tumors compared to historical data.
- Despite limited improvement in survival rates, surgical intervention is justifiable due to the potential for cure and symptom alleviation.
- This approach, combining otological and reconstructive expertise, provides satisfactory outcomes in terms of disease clearance and symptom management.