Squamous cell carcinoma (SCC) of the temporal bone is a rare, aggressive and highly malignant tumour that requires specialised, multidisciplinary surgery for its treatment. Reconstruction of the defect is as crucial as the tumour ablation in terms of mortality and postoperative morbidity.
The experience of the East Anglian Skull Base Surgery Service from 1982 to 2004 in managing 42 consecutive patients (22 females; age range 37–80 years) undergoing extended and lateral temporal bone resection for SCC is presented.
The overall 5-year survival was 31.0% (median follow up: 97 months) when both curative and palliative procedures were included. On multivariate analysis, the favourable prognostic factors were male sex, well-differentiated tumours and stage N0 neck. The reconstructions in 38 patients were analysed. The majority (24/38) had free tissue transfer reconstructions and most of these were radial forearm free flaps. Later in the series, other free flap types such as anterolateral thigh flaps and lateral arm flaps were employed. Pedicled myocutaneous flaps and local flaps were also used.
This paper analyses the outcomes of the various reconstructions and discusses the evolution of their care in our unit. The information obtained from the review of our data is extrapolated to offer guidance on the choice of reconstructive option in these patients.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Epidemiology of cancer of the middle ear cleft.Cancer. 1984; 53: 1612-1617
- The outcome of radical surgery and postoperative radiotherapy for squamous carcinoma of the temporal bone.Laryngoscope. 2005; 115: 341-347
- Coverage of skull base defects.Clin Plast Surg. 2001; 28: 375-387
- Reconstruction of the cranial base defect.Clin Plast Surg. 1995; 22: 71-77
- Reconstruction management of cranial base defects after tumour ablation.Plast Reconstr Surg. 2001; 107: 1346-1355
- Flap selection in cranial base reconstruction.Plast Reconstr Surg. 1996; 98: 1159-1166
- Cranial-base surgery: a reconstructive algorithm.Br J Plast Surg. 2003; 56: 10-13
- Petrosectomies for invasive tumours: surgery & reconstruction.Br J Plast Surg. 1996; 49: 370-378
- Reconstruction of lateral skull base oncological defects: the role of free tissue transfer.Ann Plast Surg. 1998; 41: 633-639
- Contemporary skull base reconstruction.Curr Opin Otolaryngol Head Neck Surg. 2004; 12: 294-299
- The arterial anatomy of skin flaps.2nd ed. Churchill Livingstone, Edinburgh1994
- Complications of skull base surgery.Clin Plast Surg. 1995; 22: 573-580
- Microvascular free tissue transfer in reconstructing skull base defects: lessons learned.Laryngoscope. 2002; 112: 1871-1876
- The free thigh flap: a new free flap concept based on the septocutaneous artery.Br J Plast Surg. 1984; 37: 149-159
- Anterolateral thigh flap: an ideal soft tissue flap.Clin Plast Surg. 2003; 30: 383-401
- The lateral arm flap.Clin Plast Surg. 2001; 28: 367-373
- Fasciocutaneous vessels in the upper arm: application to the design of new fasciocutaneous flaps.Plast Reconstr Surg. 1983; 74: 244-250
- Influence of radiotherapy on microvascular reconstruction in head & neck region.Am J Surg. 1991; 161: 404-407
- The principles and art of plastic surgery. vol. 1. Brown, Little and Company, Boston1957 ([chapter 3])
Published online: February 02, 2007
Accepted: November 6, 2006
Received: May 3, 2006
☆Presented at the British Association of Plastic Surgeons Winter Meeting, London, December 2005.
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.