Squamous Cell Carcinoma Involving the Temporal Bone: Lateral Temporal Bone Resection as Primary Intervention

Objective: To provide an up-to-date review of treatment and outcomes of patients with squamous cell carcinoma (SCCA) involving the temporal bone. Design: Retrospective cohort study of all patients treated at our institution for SCCA of the temporal bone between 1995 and 2007 with follow-up until 2011. Factors evaluated were demographics, presenting findings, follow-up time, previous treatment, workup, stage, surgical intervention, adjuvant therapy, histopathologic findings, recurrence, and survival. Setting: Tertiary care academic medical center. Patients: Thirty patients with SCCA of the temporal bone, originating from the external auditory canal and adjacent sites. Intervention: Surgical resection +/- adjuvant therapy. Lateral temporal bone resection was the primary and most aggressive procedure performed. Main Outcome Measures: Disease-free survival. Results: The overall disease free survival for this series when considering both external auditory canal and adjacent site SCCAs was 70%. When evaluated by tumor stage, disease-free survival was as follows: T1 tumors = 100%, T2 tumors = 100%, T3 tumors = 67%, and T4 tumors = 56%. Aggressive tumors of this series originating at periauricular sites behaved in a similar manner to primary canal tumors. Need for surgical resection of CN VII was associated with diminished survival on multivariate analysis. Conclusion: Lateral temporal bone resection provides comparable disease free survival rates to more radical surgical therapy. Such resection is appropriate for many SCCAs of the external auditory canal and adjacent sites, as these tumors are similar in disease progression and prognosis. CN VII involvement portends a poor outcome.