Abstract
Objectives Lateral temporal bone malignancy remains a challenging rare disease. We report 17
years of multidisciplinary care of these tumors with univariate and multivariate analyses
of key prognostic indicators for consideration in contemporary oncological management.
Design This is a retrospective cohort study.
Setting This is set at a tertiary referral center.
Participants All patients presenting with histopathologically newly diagnosed cases of temporal
bone malignancy between 2000 and 2017 were included.
Main Outcome Measures The main outcome measures are disease-specific and recurrence-free survival rates.
Results In this study, 48 cases of temporal bone malignancy were diagnosed. Median age at
diagnosis was 69 years (range: 5–88). Fourteen patients were female. Squamous cell
carcinoma was the predominant malignancy in 34 cases (71%). Surgical treatment was
undertaken in 37 patients. Mean length of follow-up was 32 months (range: 0.7–117).
Overall 5-year disease-specific survival was 52.4%, while overall 5-year recurrence-free
survival was 53.5%. On univariate analysis, significantly worse survival was seen
in females (p = 0.008), those with distant metastatic disease (p = 0.041), and in middle ear involvement (p = 0.012) with no difference for involvement of the external auditory canal (p = 0.98) or mastoid (p = 0.78). Only middle ear involvement remained significant on multivariate analysis.
Conclusion A wide variety of malignant pathology may present in the temporal bone. Recurrence-free
survival is equivalent to international data; however, this figure is low. This emphasizes
the need to treat these tumors appropriately with radical resection, where possible,
at first presentation. Therefore, multidisciplinary surgical input is recommended.
Middle ear involvement was a negative prognosticator for disease-specific and recurrence-free
survivals.
Keywords
temporal bone malignancy - squamous cell carcinoma - temporal bone resection - middle
ear involvement - skull base
