Results of Surgical Treatment of Temporal Bone Carcinoma

Hypothesis: There is a difference in clinical characteristics and results of surgical treatment for primary and secondary temporal bone carcinoma.

Background: Carcinoma of the temporal bone is rare, but it has considerable malignant potential. Carcinoma of the external ear canal is less aggressive and has a higher 5-year survival rate than carcinoma of the middle ear. Critical evaluation of therapeutical results of these tumors is difficult because of unequal classification.

Methods: To analyze the results of surgical and radiation therapy of these carcinomas, we divided them into primary (9 patients) and secondary tumors (12 patients) according to Arriaga et al (1990). Partial temporal bone resection was done in 7 patients, subtotal resection (petrosectomy) in 11, and total temporal bone resection in 2 patients. Postoperative irradiation during 6 weeks with 6000 cGy in 30 fractions was also applied.

Results: Five-year survival rate for primary carcinoma decreased from 100% for group A to 33% for group B, and to 0% for group C. For secondary carcinoma this rate decreased from 75%, to 66%, and finally to 0% for the same clinical groups.

Conclusion: Prognosis of temporal bone carcinoma depends directly on the propagation of the tumor. Computerized tomography is a reliable method for determining propagation and for planning the treatment. Temporal bone resection with postoperative irradiation is the method of choice of temporal bone carcinoma. Significant differences in clinical characteristics between primary and secondary invasive temporal bone tumors were found. Adequate selection of patients, choice of surgical resection, reconstruction, and postoperative radiotherapy can achieve a better survival rate and can improve patients' quality of life.