Management of the temporal bone defect after resection of external auditory canal cancer

Auris Nasus Larynx. 2021 Dec;48(6):1157-1161. doi: 10.1016/j.anl.2021.02.003. Epub 2021 Feb 25.

Abstract

Objective: To evaluate the surgical procedures used to treat external auditory canal cancer with respect to avoiding postoperative infection of the temporal bone defect.

Methods: Enrolled in the study were 52 patients with external auditory canal cancer surgically treated between July 2015 and October 2020 (38 lateral temporal bone resections, 12 subtotal temporal bone resections and 2 partial resections, accompanied by various combined procedures). Retrospective chart review was conducted taking into consideration postoperative infection, and univariate analysis of prognostic factors was performed.

Results: In cases managed with subtotal temporal bone resection, no postoperative infections occurred. Cases managed with subtotal temporal bone resection demonstrated increased use of free-flap reconstruction, and longer antibiotic infusion period. On the other hand, analysis of cases managed with lateral temporal bone resection revealed 10 out of 38 patients with postoperative infection (26.3%). However, we couldn't find out any factors that contributed significantly to the prevention of postoperative infection, including the surgical procedures used to manage the defected space, which included free-flap implantation, obliteration with fat tissue, muscular flap rotation, and leaving the space empty without obliteration or reconstruction.

Conclusion: In cases managed with lateral temporal bone resection, leaving the resected space empty did not increase the risk of infection. On the other hand, in cases with subtotal temporal bone resection, filling the surgical defect with an autologous bulk, including the free-flap reconstruction and fat obliteration, seems to prevent the infection. Moreover, prolonged antibiotic infusion may suppress postoperative infection of the temporal bone defect.

Keywords: External auditory canal cancer; Lateral temporal bone resection; Post-operative infection; Subtotal temporal bone resection.

MeSH terms

  • Aged
  • Analysis of Variance
  • Anti-Bacterial Agents / therapeutic use
  • Disease-Free Survival
  • Ear Canal / surgery*
  • Ear Neoplasms / surgery*
  • Female
  • Free Tissue Flaps
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / prevention & control*
  • Temporal Bone / surgery*

Substances

  • Anti-Bacterial Agents