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Ordoyne LM, Alvarez I, Borne G, Fabian I, Adilbay D, Kandula RA, Asarkar AA, Nathan CAO, Olinde L, Pang J. Risk Factors for Complications in Patients Undergoing Temporal Bone Resection and Neck Dissection: Insights From a National Database. Ann Otol Rhinol Laryngol 2024:34894241252541. [PMID: 38712888 DOI: 10.1177/00034894241252541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
BACKGROUND Temporal bone resection (TBR) with or without neck dissection (ND) is performed for otologic malignancies with occult or clinical cervical lymph node metastases. To date, characterization of post-operative complications in single institution case series may be non-representative of real-world outcomes. Here, we used data from the National Inpatient Sample (NIS) to comprehensively assess the complications encountered, their frequencies, and to identify underlying risk factors to improve future outcomes. METHODS The population was patients undergoing TBR and ND derived from the NIS between the years of 2017 and 2019. We utilized ICD-10 diagnosis codes to identify patients with post-operative complications, those discharged to non-home facilities (DNHF), and those with increased length of stay (LOS). Multivariable regression was performed to identify significant variables related to the above outcomes. RESULTS Ninety of 277 patients that underwent LTBR with ND had postoperative complications. Wound complications were the most frequent complication, occurring in 11 (4%) of patients, followed by CSF leak (n = 6; 2.2%), with acute respiratory failure being the most common medical complication (n = 4; 1.4%). Sixteen percent (45/277) were discharged to a facility besides home. Dementia (OR = 7.96; CI95 3.62-17.48), anemia (OR = 2.39; CI95 1.15-4.99), congestive heart failure (OR = 5.31; CI95 1.82-15.45), COPD (OR = 3.70; CI95 1.35-10.16), and history of prior stroke (OR = 8.50; CI95 1.55-46.68) increased the odds of DNHF. When evaluating LOS (median = 5 days, IQR = 1, 9), anemia (OR = 5.49; CI95 2.86-10.52), and Medicaid insurance (OR = 3.07; CI95 1.06-10.52) were found to increase the LOS. CONCLUSIONS The vast majority of patients undergoing LTBR with ND have no complications and are discharged within a week. Liver disease is a risk factor for medical complications and increased charges. Patients with dementia or a prior stroke are at risk for DNHF, and those with prior anemia are at risk for a wound complication. LAY SUMMARY This study identified factors related to worse post-operative outcomes in patients undergoing temporal bone resection and neck dissection. Although safe for most patients, an existing diagnosis of liver disease, stroke, dementia, and anemia specifically are at risk for developing negative outcomes. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Liam M Ordoyne
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
| | - Ivan Alvarez
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
| | - Grant Borne
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
| | - Isabella Fabian
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
| | - Dauren Adilbay
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
| | - Rema A Kandula
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
| | - Ameya A Asarkar
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
- Feist Weiller Cancer Center, Shreveport, LA, USA
| | - Cherie-Ann O Nathan
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
- Feist Weiller Cancer Center, Shreveport, LA, USA
| | - Lindsay Olinde
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
- Feist Weiller Cancer Center, Shreveport, LA, USA
| | - John Pang
- Department of Otolaryngology-HNS, LSU Health Sciences Center, Shreveport, LA, USA
- Feist Weiller Cancer Center, Shreveport, LA, USA
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2
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Shikano Y, Tashima H, Kuroda K, Otani N, Seike S, Kubo T. Fat-augmented Temporal Fascia Flap for Defect Coverage following External Auditory Canal Cancer Resection. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5839. [PMID: 38798943 PMCID: PMC11124592 DOI: 10.1097/gox.0000000000005839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/04/2024] [Indexed: 05/29/2024]
Abstract
Malignant tumors of the external auditory canal are rare and require surgical interventions such as lateral temporal bone resection (LTBR) for localized cases. This study introduces a novel approach, the lipofilling fascia flap technique, for external auditory canal reconstruction following LTBR or modified LTBR. The technique involves augmenting the temporal fascia flap with autologous fat grafting, aiming to enhance volume and improve outcomes. Two cases are presented, demonstrating successful reconstruction with minimal complications.
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Affiliation(s)
- Yusuke Shikano
- From the Department of Plastic and Reconstructive Surgery, Osaka University Hospital, Osaka, Japan
| | - Hiroki Tashima
- Tashima Dermatology and Plastic Surgery Clinic, Osaka, Japan
| | - Kazuya Kuroda
- From the Department of Plastic and Reconstructive Surgery, Osaka University Hospital, Osaka, Japan
| | - Naoya Otani
- From the Department of Plastic and Reconstructive Surgery, Osaka University Hospital, Osaka, Japan
| | - Shien Seike
- From the Department of Plastic and Reconstructive Surgery, Osaka University Hospital, Osaka, Japan
| | - Tateki Kubo
- From the Department of Plastic and Reconstructive Surgery, Osaka University Hospital, Osaka, Japan
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3
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Gowrishankar S, Borsetto D, Marinelli J, Panizza B. Temporal bone management in external and middle ear carcinoma. Curr Opin Otolaryngol Head Neck Surg 2024; 32:138-142. [PMID: 38193562 DOI: 10.1097/moo.0000000000000959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to outline the temporal bone management of external and middle ear carcinoma. The review will outline the current evidence involved in deciding which surgical approach to take, as well as new advances in auditory rehabilitation and immunotherapy. RECENT FINDINGS Traditional surgical approaches include lateral temporal bone resection, subtotal temporal bone resection and total temporal bone resection. They can also involve parotidectomy and neck dissection depending on extension of disease into these areas. Options for auditory rehabilitation include osseointegrated hearing aids, transcutaneous bone-conduction implants, and active middle ear implants. Recent advances in immunotherapy have included the use of anti-PD-1 monoclonal antibodies. SUMMARY The mainstay of management of temporal bone disease involves surgical resection. Early-stage tumours classified according to the Pittsburgh staging tool can often be treated with lateral temporal bone resection, whereas late-stage tumours might need subtotal or total temporal bone resection. Parotidectomy and neck dissection might also be indicated if there is a risk of occult regional disease. Recent advances in immunotherapy have been promising, particularly around anti-PD-1 inhibitors. However, larger clinical trials will be required to test the extent of efficacy, particularly around combination use with surgery.
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Affiliation(s)
- Shravan Gowrishankar
- Department of Otolaryngology - Head & Neck Surgery, Cambridge University Hospitals NHS Trust
| | - Daniele Borsetto
- Department of Otolaryngology - Head & Neck Surgery, Cambridge University Hospitals NHS Trust
| | - John Marinelli
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ben Panizza
- Department of Otolaryngology - Head & Neck surgery, Princess Alexandra Hospital, Brisbane, QLD, Australia
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4
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de Castro MERV, Ferreira-Pinto PHC, de Oliveira Ferreira DBC, Brito ACG, Parise M, Correa EM, Cruz TZ, de Freitas WKN, de Gouvea PLRC, da Silva WN, de Sousa BC, Videira HFM, Parra GF, Nigri F. Temporal bone squamous cell carcinoma: Aggressive behavior coursing with cerebellar invasion and hydrocephalus. Surg Neurol Int 2024; 15:89. [PMID: 38628504 PMCID: PMC11021098 DOI: 10.25259/sni_1017_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/17/2024] [Indexed: 04/19/2024] Open
Abstract
Background Temporal bone squamous cell carcinoma (TBSCC) is a very rare condition. The prognosis is dismal for advanced tumors. Due to its rarity, information in the literature is scarce. Here, we report a unique case of TBSCC with cerebellar invasion and hydrocephalus. Case Description A 46-year-old reported right-sided hearing loss and a painful right retroauricular mass for 4 months. Magnetic resonance imaging revealed a 8.7 × 7.6 × 6.4 cm mass invading the right temporal and occipital bones. After a biopsy and 3 surgical procedures over 6 months, the diagnosis of TBSCC was obtained. Due to invasion of the cerebellar tissue and obstructive hydrocephalus, a ventriculoperitoneal shunt was performed. The patient was referred for adjuvant radiotherapy. However, palliative care was initiated due to tumor progression. Conclusion We report a case of advanced TBSCC with poor prognosis despite surgical treatment and radiotherapy. More data are necessary to provide new and better treatment to these patients.
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Affiliation(s)
| | | | | | | | - Maud Parise
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Eduardo Mendes Correa
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Thaina Zanon Cruz
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | | | | | - Wellerson Novaes da Silva
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Bruna Cavalcante de Sousa
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | | | - Guilherme Freitas Parra
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Flavio Nigri
- Neurosurgery, Department of Surgical Specialties, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
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5
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Ahmadi P, Kazemi MA, Yazdani N, Dabiri S. Determination of the radioanatomical factors related to the position of facial nerve in accessing jugular foramen and carotid artery in temporal bone. Heliyon 2024; 10:e26560. [PMID: 38404895 PMCID: PMC10884483 DOI: 10.1016/j.heliyon.2024.e26560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Preservation of the facial nerve is of great importance in temporal bone surgeries. We intend to investigate the measurements of the radioanatomical factors related to the position of the facial nerve in accessing jugular foramen and internal carotid artery (ICA) in temporal bone of patients who were candidates for temporal high resolution computed tomography (HRCT) scan. Methods In this correlation cross-sectional study, samples were selected from patients referred to Amir Alam Hospital who were previously candidates for temporal HRCT. Radioanatomic factors were evaluated in three axial, coronal and sagittal views. Analyzes were performed using descriptive statistics, correlation analysis and factor analysis. Results A total of 173 samples were investigated. The most reliable radioanatomical factor based on coefficient of variation (CV) was the distance of the 7th nerve to the temporomandibular joint (TMJ) in the inferior to the cochlea in the sagittal view (variable name S2) (CV = 8.1%) and then the distance from the 7th nerve to the TMJ in the inferior section of the cochlea in the axial view (variable name AI3) (CV = 8.4%). Based on correlation analysis and then confirmatory factor analysis, three common latent factors were identified (overall R2 = 0.999). Conclusion The results of this study can be used for two purposes. First, the direct use of the estimated measures in surgical operations, and the second is more advanced modeling to choose the approach in the surgical operation and how to implement that approach. For the first aim, the two factors AI3 and S2 were the most reliable radioanatomical factors in different people. For the second aim, the three-dimensional understanding of the obtained measurements and the further identification of the anatomical nature of the latent factors can help in choosing the approach in surgery.
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Affiliation(s)
- Parisadat Ahmadi
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Kazemi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Complex Hospital, Tehran, Iran
| | - Nasrin Yazdani
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sasan Dabiri
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sioufi K, Haynes AD, Gidley PW, Maniakas A, Roberts D, Nader ME. Survival Outcomes of Temporal Bone Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Otolaryngol Head Neck Surg 2024. [PMID: 38341629 DOI: 10.1002/ohn.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/20/2023] [Accepted: 01/06/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Temporal bone squamous cell carcinoma (TBSCC) is a rare malignancy with poor prognosis, and optimal treatment for advanced cases is uncertain. Our systematic literature review aimed to assess 5-year survival outcomes for advanced TBSCC across different treatment modalities. DATA SOURCES EMBASE, Medline, PubMed, and Web of Science. REVIEW METHODS A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for articles published between January 1989 and June 2023. RESULTS The review yielded 1229 citations of which 31 provided 5-year survival data for TBSCC. The final analysis included 1289 patients. T classification data was available for 1269 patients and overall stage for 1033 patients. Data for 5-year overall survival (OS) was 59.6%. Five-year OS was 81.9% for T1/2 and 47.5% for T3/4 (P < .0001). OS for T1/T2 cancers did not significantly differ between surgery and radiation (100% vs 81.3%, P = .103). For advanced-stage disease (T3/T4), there was no statistical difference in OS when comparing surgery with postoperative chemoradiotherapy (CRT) (OS 50.0%) versus surgery with postoperative radiotherapy (XRT) (OS 53.3%) versus definitive CRT (OS 58.1%, P = .767-1.000). There was not enough data to assess the role of neoadjuvant CRT. CONCLUSION Most patients will present with advanced-stage disease, and nodal metastasis is seen in nearly 22% of patients. This study confirms the prognostic correlation of the current T classification system. Our results suggest that OS did not differ significantly between surgery and XRT for early stage disease, and combined treatment modalities yield similar 5-year OS for advanced cancers.
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Affiliation(s)
- Krystelle Sioufi
- Department of Family Medicine, University of Montreal, Montreal, Canada
| | - Aaron David Haynes
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Paul W Gidley
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anastasios Maniakas
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Dianna Roberts
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marc-Elie Nader
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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7
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Huang Y, Wu J, Chao W, Lee W. Treatment outcome and prognostic factors of external auditory canal squamous cell carcinoma: A retrospective study in a tertiary center. Laryngoscope Investig Otolaryngol 2024; 9:e1216. [PMID: 38362177 PMCID: PMC10866593 DOI: 10.1002/lio2.1216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/27/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024] Open
Abstract
Objective Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is a rare malignancy with various treatment strategies and outcomes. The purpose of this study was to evaluate the clinical characteristics and survival outcomes and identify prognostic factors in patients with SCC of EAC. Methods Twenty-one patients with SCC of EAC treated in a single tertiary center between 2009 and 2021 were retrospectively reviewed and analyzed. The modified Pittsburgh classification system was applied for staging. Factors associated with survival were identified by univariate survival analysis. Results The mean age at diagnosis was 61 years (range: 41-79 years). Early-stage (T1 + T2) accounts for 38.1% of the series and advanced-stage (T3 + T4) accounts for 61.9%. Eighteen (85.7%) patients underwent primary surgery with curative intent. The 5-year overall survival rate of the 21 patients was 67.4%. Tumor invasion to the otic capsule, eustachian tube, sigmoid sinus, and dura were associated with poor prognosis in univariate analysis (p = .046; .008; .027; and .08, respectively). Conclusions Factors predictive of less favorable survival include the history of COM, tumor invasion to the otic capsule, eustachian tube, sigmoid sinus, and dura. It is important to make a precise and systemic preoperative evaluation of disease extent. Level of Evidence 4.
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Affiliation(s)
- Yi‐Ting Huang
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan CityTaiwan
| | - Jiunn‐Liang Wu
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan CityTaiwan
| | - Wen‐Yuan Chao
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan CityTaiwan
| | - Wei‐Ting Lee
- Department of OtolaryngologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan CityTaiwan
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Patel TR, Prince ADP, Benjamin WJ, Basura GJ. Role of the otologist/neurotologist in managing auricular and periauricular cutaneous malignancies: A 10-year otologic oncology experience. Laryngoscope Investig Otolaryngol 2023; 8:1637-1647. [PMID: 38130268 PMCID: PMC10731494 DOI: 10.1002/lio2.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/14/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
Objective Auricular/periauricular cutaneous malignancies can be challenging to manage surgically due to the complex anatomy of the region. Otologists/neurotologists have unique skillsets that are well-suited to surgically treat these patients. We aim to highlight the role of otologists and neurotologists in providing surgical care of patients with auricular and periauricular malignancies by describing the experience of a single fellowship-trained neurotologist over a 10-year period. Methods Retrospective chart review of 387 patients with auricular and periauricular malignancy treated by a single neurotologist between 2012 and 2022 was completed. Tumor histology and procedures performed for each patient were extracted. Additional data was collected for a subset of 84 patients with complex cases requiring selective neck dissection, parotidectomy, lateral temporal bone resection, regional advancement or rotational flap reconstruction, and/or free tissue transfer reconstruction. Results Within the series of 387 patients, squamous cell carcinoma was the most common histology (42.6%, n = 165), followed by basal cell carcinoma (40.8%, n = 158), and melanoma (9.8%, n = 38). Common surgical procedures included wide local excision (61.8%, n = 239), partial/sub-total auriculectomy 18.3% (n = 71), or total auriculectomy 5.2% (n = 20). Within the 84-patient subset, median age at diagnosis was 71.9 years. Dermatologists provided most patient referrals (50.0%, n = 42). Most common tumor locations included: auricular (58.3%, n = 49), pre-auricular (21.4%, n = 18), and parotid (27.4%, n = 23). Revision surgery occurred in 22.6% of cases (n = 19), of which 26.3% (n = 5) for positive margins and 31.6% (n = 6) for recurrence. Mean follow-up was 22.8 months. Disease-specific 5-year survival was 91%. Conclusions We demonstrate the feasibility of an otologist/neurotologist incorporating the surgical management of auricular and periauricular malignancies into their practice. Level of Evidence 4.
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Affiliation(s)
- Tirth R. Patel
- Department of Otorhinolaryngology‐Head and Neck SurgeryRush UniversityChicagoIllinoisUSA
| | - Andrew D. P. Prince
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of MichiganAnn ArborMichiganUSA
| | - William J. Benjamin
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of MichiganAnn ArborMichiganUSA
| | - Gregory J. Basura
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of MichiganAnn ArborMichiganUSA
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9
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Raymond M. Neoplasms of the Ear Canal. Otolaryngol Clin North Am 2023; 56:965-976. [PMID: 37495430 DOI: 10.1016/j.otc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Primary EAC neoplasms include benign and malignant lesions of bony, glandular or cutaneous origin. Small, benign slow growing bony neoplasms are often asymptomatic, diagnosed incidentally and might not require intervention. Both malignant and benign neoplasms of cutaneous and glandular origin can present with symptoms of chronic otitis externa, leading to delays in diagnosis. Prompt biopsy of soft tissue lesions associated with non-resolving otitis externa are warranted. Local and regional imaging is helpful to understand disease extent and origin, but even early-stage malignant neoplasms require aggressive surgical treatment.
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Affiliation(s)
- Mallory Raymond
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Florida, 4500 San Sablo Drive, Jacksonville, FL 32224, USA.
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10
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Fukumoto I, Mita Y, Shimmi R, Sonobe Y, Iinuma T, Yamasaki K, Yonekura S, Nemoto T, Hanazawa T. Preoperative simulation using three-dimensional printer in four temporal bone surgeries. Clin Case Rep 2023; 11:e7135. [PMID: 37192847 PMCID: PMC10182005 DOI: 10.1002/ccr3.7135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 05/18/2023] Open
Abstract
Preoperative simulation using a three-dimensional printer is effective to perform safe surgery by knowing the range limit of drilling in the temporal bone. Moreover, simulations using models are thought to be useful for education of young surgeon.
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Affiliation(s)
- Ichiro Fukumoto
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Yukiyoshi Mita
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Rie Shimmi
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Yuri Sonobe
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Tomohisa Iinuma
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Kazuki Yamasaki
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Shuji Yonekura
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
| | - Toshimitsu Nemoto
- Department of OtorhinolaryngologyJapanese Red Cross Narita HospitalNaritaJapan
| | - Toyoyuki Hanazawa
- Department of Otorhinolaryngology/Head and Neck SurgeryChiba University Graduate School of MedicineChibaJapan
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11
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Cazzador D, Franz L, Tealdo G, Carobbio ALC, Ferraro M, Mazzoni A, Marioni G, Zanoletti E. Survival Outcomes in Squamous Cell Carcinoma of the External Auditory Canal: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12072490. [PMID: 37048574 PMCID: PMC10094887 DOI: 10.3390/jcm12072490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Squamous cell carcinomas (SCC) of the external auditory canal (EAC) are rare tumors representing a surgical challenge. Current knowledge is based largely on case series; thus, the level of evidence is weak. This study sought to systematically review the available SCC of the EAC literature and to identify risk factors for overall survival (OS) and disease-specific survival (DSS). A systematic review and meta-analysis of papers searched up to December 2022 through PubMed, Scopus, Web of Science, and Cochrane Library databases was conducted. Quality assessment of the eligible studies was done according to the Newcastle-Ottawa Scale. Pooled univariate and multivariable analyses and meta-analysis using a random-effects or fixed-effects Mantel-Haenszel model were performed. Fifteen articles (282 patients) met the inclusion criteria and were included in the quantitative analysis. The pooled multivariable analysis revealed cT3 and cT4 as independent prognostic factors for OS (p = 0.005, and p < 0.001, respectively) and DSS (p = 0.002, and p < 0.001, respectively). Local recurrence rate was 32.3%. The meta-analysis estimated significantly higher odds ratios for advanced T categories, than cT1-T2 tumors for OS and DSS (OR = 3.55; 95% CI, 1.93–6.52, and OR = 3.73; 95% CI, 2.00–6.97, respectively). In conclusion, locally advanced tumors were associated with poor prognosis. Poor outcomes mostly occurred due to local recurrence.
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12
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McCracken M, Pai K, Cabrera CI, Johnson BR, Tamaki A, Gidley PW, Manzoor NF. Temporal Bone Resection for Squamous Cell Carcinoma of the Lateral Skull Base: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 168:154-164. [PMID: 35290141 DOI: 10.1177/01945998221084912] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/11/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Temporal bone squamous cell carcinoma (TBSCC) is rare and often confers a poor prognosis. The aim of this study was to synthesize survival and recurrence outcomes data reported in the literature for patients who underwent temporal bone resection (TBR) for curative management of TBSCC. We considered TBSCC listed as originating from multiple subsites, including the external ear, parotid, and external auditory canal (EAC), or nonspecifically from the temporal bone. DATA SOURCES PubMed, Cochrane Library, Embase, and manual search of bibliographies. REVIEW METHOD A systematic literature review conducted in December 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Survival data were collected from 51 retrospective studies, resulting in a pooled cohort of 501 patients with TBSCC. Compared to patients undergoing lateral TBR (LTBR), patients undergoing subtotal (SBTR) or total (TTBR) TBR exhibited significantly higher rates of stage IV disease (P < .001), positive surgical margins (P < .001), facial nerve involvement (P < .001), and recurrent disease (P < .001). A meta-analysis of 15 studies revealed a statistically significant 97% increase in mortality in patients who underwent STBR or TTBR. On multivariate analysis, recurrent disease was independently associated with worse overall survival (P < .001). On univariate analysis, facial nerve involvement was also associated with decreased overall survival (P < .001). CONCLUSION Recurrent disease was associated with risk of death in patients undergoing TBR. Larger prospective multi-institutional studies are needed to ascertain prognostic factors for a wider array of postoperative outcomes, including histology-specific survival and recurrence outcomes.
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Affiliation(s)
- Matthew McCracken
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Kavya Pai
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Claudia I Cabrera
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Benjamin R Johnson
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Akina Tamaki
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Paul W Gidley
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - Nauman F Manzoor
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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13
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Pan W, Zhang C, Chen M, Min S, Xu L, Chi Z. Expression of Ki-67 and P16 are related with HPV in squamous cell carcinoma of the external auditory canal. JOURNAL OF OTOLARYNGOLOGY - HEAD & NECK SURGERY 2022; 51:40. [DOI: 10.1186/s40463-022-00592-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Squamous cell carcinoma of the external auditory canal (EACSCC) is an uncommon tumor and responsible for no more than 0.2% of all the head and neck malignancies. Although there is remarkable research evidence exhibiting that high-risk human papillomavirus (HPV) accounts for considerable head and neck malignancies, its role in the pathogenesis of EACSCC is yet to be determined.
Methods
We evaluated 16 patients with EACSCC treated at our department. We employed PCR to assay for high-risk subtypes of HPV. Two pathologists reviewed the histopathological staining via hematoxylin and eosin along with immunohistochemical staining of p16INK4a and Ki‑67.
Results
Detection of HPV DNA was done via PCR in 3 (18.75%) patients, and 8 (50%) positive (+) cases were determined via p16INK4a immunostaining. Besides, 3 (37.5%) individuals were HPV positive as per p16INK4a PCR results. In addition, all of the p16INK4a-positive specimens were diagnosed as moderately differentiated carcinomas.
Conclusions
Expression of Ki-67 was related to HPV status. This is the first report implicating high-risk HPV in squamous cell carcinoma of the external auditory canal. However, p16INK4a immunostaining is a suspectable approach for diagnosing HPV for EACSCC. In addition, HPV might enhance an elevated proliferation rate in EACSCC, illustrated via expression of Ki-67.
Graphical Abstract
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14
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肖 龙, 刘 爱, 马 华, 江 红. [Current status of the diagnosis and treatment of temporal bone squamous cell carcinoma]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:559-565. [PMID: 35822388 PMCID: PMC10128389 DOI: 10.13201/j.issn.2096-7993.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 06/15/2023]
Abstract
Temporal bone squamous cell carcinoma, which is rare in the clinical setting, is the most common type of temporal bone malignancy. Its rarity makes the staging, the way of temporal bone resection, the management of parotid gland and cervical lymph node, and the application of radiotherapy and chemotherapy still controversial.There is no unanimous consensus and guideline about it to date at home and abroad.This paper reviewed the recent advance in the diagnosis and treatment of temporal bone squamous cell carcinoma in the hope of providing some help and reference for the management of the disease.
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Affiliation(s)
- 龙开 肖
- 南昌大学第一附属医院耳鼻咽喉头颈外科(南昌,330006)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - 爱国 刘
- 华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Huazhong University of Science and Technology
| | - 华良 马
- 华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Huazhong University of Science and Technology
| | - 红群 江
- 南昌大学第一附属医院耳鼻咽喉头颈外科(南昌,330006)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
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15
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Nabuurs CH, Kievit W, Leemans CR, Smit CFGM, van den Brekel MWM, Pauw RJ, van der Laan BFAM, Jansen JC, Lacko M, Braunius WW, Dai C, Shi X, Danesi G, Bouček J, Takes RP, Kunst HPM. Evaluation of subclasses for T4-classified squamous cell carcinoma of the external auditory canal. Head Neck 2022; 44:1787-1798. [PMID: 35560966 PMCID: PMC9541903 DOI: 10.1002/hed.27082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/02/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background T4‐classified squamous cell carcinoma (SCC) of external auditory canal (EAC) can potentially involve different anatomical structures, which could translate into different treatment strategies and survival outcomes within one classification. Our aim is to evaluate the clinical added value of T4‐subclasses proposed by Lavieille and by Zanoletti. Methods Retrospective data, including patients with primary operated cT4‐classified EAC SCC, was obtained from 12 international hospitals. We subclassified according to the T4‐subclasses. The treatment strategies, disease‐free survival (DFS) and overall survival per subclass were calculated. Results A total of 130 T4‐classified EAC SCC were included. We found commonly used treatment strategies per subclass according to Lavieille and the DFS seems also to differ per subclass. Subclass according to Zanoletti showed comparable treatment strategies and survival outcomes per subclass. Conclusion Our study suggests that the subclass according Lavieille might have added value in clinical practice to improve care of T4‐classified EAC SCC.
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Affiliation(s)
- Cindy H Nabuurs
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Wietske Kievit
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C René Leemans
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam University Medical Centers, VU University, Amsterdam, the Netherlands
| | - Conrad F G M Smit
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam University Medical Centers, VU University, Amsterdam, the Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Robert J Pauw
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery, Haaglanden Medical Center, The Hage, the Netherlands
| | - Jeroen C Jansen
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Martin Lacko
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Weibel W Braunius
- Department of Head and Neck Surgical Oncology, University Medical Center/Utrecht Cancer Center, Utrecht, the Netherlands
| | - Chunfu Dai
- Department of Otology & Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China
| | - Xunbei Shi
- Department of Otology & Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China
| | - Giovanni Danesi
- Department of Otorhinolaryngology and Skull Base Microsurgery-Neurosciences, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Jan Bouček
- Department of Otorhinolaryngology and Head and Neck Surgery, The First Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic
| | - Robert P Takes
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Henricus P M Kunst
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Maastricht University Medical Center, Maastricht, the Netherlands
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16
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Temporal Bone Squamous Cell Carcinoma: Molecular Markers Involved in Carcinogenesis, Behavior, and Prognosis: A Systematic Review. Int J Mol Sci 2022; 23:ijms23094536. [PMID: 35562926 PMCID: PMC9100168 DOI: 10.3390/ijms23094536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 02/07/2023] Open
Abstract
Temporal bone squamous cell carcinoma (TBSCC) is an uncommon malignancy with a poor prognosis in advanced cases. The dismal outcome of advanced TBSSC cases is largely due to the cancer’s local aggressiveness and the complex anatomy of this region, as well as to persistent pitfalls in diagnosis and treatment. Molecular changes occur in malignancies before any morphological changes become visible, and are responsible for the disease’s clinical behavior. The main purpose of this critical systematic review is to assess the level of knowledge on the molecular markers involved in the biology, behavior, and prognosis of TBSCC. A search (updated to March 2022) was run in PubMed, Scopus, and Web of Science electronic databases without publication date limits for studies investigating molecular markers in cohorts of patients with primary TBSCC. The search terms used were: “temporal bone” OR “external auditory canal” OR “ear”, AND “cancer” OR “carcinoma” OR “malignancy”. We preliminarily decided not to consider series with less than five cases. Twenty-four case series of TBSCC were found in which different analytical techniques had been used to study the role of several biomarkers. In conclusion, only very limited information on the prognostic role of molecular markers in TBSCC are currently available; prospective, multi-institutional, international prognostic studies should be planned to identify the molecular markers involved in the clinical behavior and prognosis of TBSCC. A further, more ambitious goal would be to find targets for therapeutic agents able to improve disease-specific survival in patients with advanced TBSCC.
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17
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Tsuno NSG, Tsuno MY, Coelho Neto CAF, Noujaim SE, Decnop M, Pacheco FT, Souza SA, Fonseca APA, Garcia MRT. Imaging the External Ear: Practical Approach to Normal and Pathologic Conditions. Radiographics 2022; 42:522-540. [PMID: 35119966 DOI: 10.1148/rg.210148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The external ear (EE) is an osseous-cartilaginous structure that extends from the auricle to the tympanic membrane. It is divided into two parts: the auricle (or pinna) and the external auditory canal (EAC). Given the ease of access to the EE, imaging studies are not always needed to make a diagnosis. However, when lesions block visual access to areas deep to the EE abnormality, complications are suspected, or there is lack of response to treatment, imaging becomes essential. A basic understanding of the embryologic development and knowledge of the anatomy of the auricle and EAC are useful for accurate diagnosis of EE lesions. Congenital, traumatic, inflammatory, neoplastic, and vascular conditions can affect the EE. An overview of the anatomy and embryologic development of the EE is presented, with discussion and illustrations of common and uncommon conditions that affect EE structures and a focus on the CT and MRI features that are of interest to radiologists. CT is usually the first diagnostic modality used to evaluate the EAC and is the superior method for demonstrating bone changes. MRI provides excellent tissue characterization and enables one to better define lesion extension and perineural tumor spread. In addition, a flowchart to facilitate the differential diagnosis of EE abnormalities is provided. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Niedja S G Tsuno
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Marco Y Tsuno
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Carlos A F Coelho Neto
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Samir E Noujaim
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Marcos Decnop
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Felipe T Pacheco
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Soraia A Souza
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Ana P A Fonseca
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Marcio R T Garcia
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
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18
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Zhong S, Zuo W. Treatment Strategies for Malignancies of the External Auditory Canal. Curr Treat Options Oncol 2022; 23:43-53. [PMID: 35167009 PMCID: PMC8891096 DOI: 10.1007/s11864-021-00931-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/30/2022]
Abstract
Malignant tumors of the external auditory canal (EAC) are rare tumors in the head and neck. Delayed diagnosis is not uncommon because the symptoms of early tumors are nonspecific. Various surgical and oncological treatment modalities have been reported. Decision-making depends on pathological feature and stage of the lesions, patient’s general condition and preference, and physician’s experience and skill. Radical surgery is widely accepted as the primary treatment of choice. Postoperative radiotherapy is used more often to improve local and regional control of the disease. Chemotherapy is usually recommended for advanced disease, residual disease, and metastasis. Prognosis is affected by multiple factors such as TNM stage, surgical margin, pathological type and differentiation of tumor, involvement of facial nerve, and so on. Although the survival rate is improved significantly over the past several decades with the development of skull base surgery, neuroradiology, anesthesiology, and oncology, it remains challenging to diagnose and treat EAC malignancies due to the rarity, the local anatomical complexity of temporal bone, and the lack of standard TNM staging system.
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Affiliation(s)
- Shixun Zhong
- Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
| | - Wenqi Zuo
- Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
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19
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Yanez-Siller JC, Wentland C, Bowers K, Litofsky NS, Rivera AL. Squamous Cell Carcinoma of the Temporal Bone Arising from Cholesteatoma: A Case Report and Review of the Literature. J Neurol Surg Rep 2022; 83:e13-e18. [PMID: 35155077 PMCID: PMC8824697 DOI: 10.1055/s-0041-1741069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Objective
Present a case of squamous cell carcinoma of the temporal bone (SCCTB) arising in a 61-year-old female with a prior history of cholesteatoma and persistent otologic symptoms and review the current literature regarding this disease presentation.
Setting
Tertiary academic center.
Patient
A 61-year-old female with a history of left ear cholesteatoma for which she had undergone surgery 54 years prior. The patient presented with a persistent history of otorrhea since first surgery and developed exacerbation of symptoms just prior to presentation at our department. The clinical picture was highly suspicious of cholesteatoma recurrence. However, the biopsy was consistent with squamous cell carcinoma.
Intervention
Surgical debulking of the lesion was followed by a brief course of radiation therapy later halted by the patient due to side effect intolerance.
Conclusion
SCCTB may arise from cholesteatoma. A high index of suspicion for SCCTB should be maintained in patients with a prior history of cholesteatoma and evidence of a temporal bone mass with persistent otologic symptoms.
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Affiliation(s)
- Juan C Yanez-Siller
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, United States
| | - Carissa Wentland
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, United States
| | - Kelly Bowers
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, United States
| | - N Scott Litofsky
- Division of Neurosurgery, Department of Surgery, University of Missouri, Columbia, Missouri, United States
| | - Arnaldo L Rivera
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, United States
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20
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Goto S, Nishio N, Iwami K, Yoshida T, Maruo T, Mukoyama N, Tsuzuki H, Yokoi S, Wada A, Hiramatsu M, Hayashi Y, Kamei Y, Fujii M, Sone M, Fujimoto Y. Surgical Strategy for Squamous Cell Carcinoma of the External Auditory Canal: Management of Locally Advanced Cases with Skull Base Involvement. J Neurol Surg B Skull Base 2022; 84:69-78. [PMID: 36743718 PMCID: PMC9897898 DOI: 10.1055/a-1733-2585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/04/2022] [Indexed: 02/07/2023] Open
Abstract
Objective Surgical indications for advanced-stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) are highly dependent on the skull base surgery team. The aim of this study was to evaluate the surgical outcomes in patients with SCC of the EAC and to clarify the surgical indication of far advanced cases using the T4 subclassification. Methods Patients with SCC of the EAC who underwent curative treatment from 2002 to 2021 at our hospital were retrospectively reviewed. Clinical and surgical results, including operative data, overall survival (OS), and disease-specific survival (DSS), were analyzed. To clarify the surgical indication for advanced-stage tumors, we proposed the T4 subclassification. Results In the 46 patients included in the study, 8 patients had T1 tumors, 10 had T2 tumor, 5 had T3 tumors, and 23 had T4 tumors. The 5-year DSS with T1, T2, T3, and T4 tumors were 100, 85.7, 100, and 61.7%, respectively. No prognostic impacts for margin status were found between the 5-year OS and DSS ( p = 0.23 and 0.13, respectively). Patients with far-advanced-stage (T4b) tumors were significantly associated with shorter DSS than those with early-stage (T1/T2) and advanced-stage (T3/T4a) tumors ( p = 0.007 and 0.03, respectively). Conclusion The present study focused on patients with SCC of the EAC at a university hospital over a period of 20 years, especially with skull base involvement, and a T4 subclassification was proposed. Complete tumor resection in an en bloc fashion could help achieve a good survival rate even in patients with locally advanced tumors.
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Affiliation(s)
- Seiya Goto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan,Address for correspondence Naoki Nishio, MD, PhD Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine65, Tsurumai-cho, Showa-ku, Nagoya 466-8550Japan
| | - Kenichiro Iwami
- Department of Neurosurgery, Aichi Medical University, Aichi, Japan
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Maruo
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuaki Mukoyama
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidenori Tsuzuki
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayaka Yokoi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihisa Wada
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mariko Hiramatsu
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuichiro Hayashi
- Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | - Yuzuru Kamei
- Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masazumi Fujii
- Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan,Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Aichi, Japan
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21
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Komune N, Kuga D, Miki K, Nakagawa T. Variations of en Bloc Resection for Advanced External Auditory Canal Squamous Cell Carcinoma: Detailed Anatomical Considerations. Cancers (Basel) 2021; 13:4556. [PMID: 34572783 PMCID: PMC8470502 DOI: 10.3390/cancers13184556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 12/15/2022] Open
Abstract
Currently, only lateral temporal bone resection (LTBR) and subtotal temporal bone resection (STBR) are widely utilized for the surgical treatment of advanced squamous cell carcinoma of the external auditory canal (EAC-SCC). However, there are few descriptions of variations on these surgical approaches. This study aimed to elucidate the variations of en bloc resection for advanced EAC-SCC. We dissected the four sides of cadaveric heads to reveal the anatomical structures related to temporal bone resection. From the viewpoint of surgical anatomy, surgical patterns of temporal bone cutting can be divided into four categories: conventional LTBR, extended LTBR, conventional STBR, and modified STBR. Extended LTBR is divided into four types: superior, inferior, anterior, and posterior extensions. Several extension procedures can be combined based on the extension of the tumor. Furthermore, en bloc resection with the temporomandibular joint or glenoid fossa increases the technical difficulty of a surgical procedure because the exposure and manipulation of the petrous segment of the internal carotid artery are limited from the middle cranial fossa. Surgical approaches for advanced SCC of the temporal bone are diverse. They require accurate preoperative evaluation of the tumor extension and preoperative consideration of the exact line of resection to achieve marginal negative resection.
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Affiliation(s)
- Noritaka Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Daisuke Kuga
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Koichi Miki
- Department of Neurosurgery, Fukuoka University Hospital and School of Medicine, Fukuoka 814-0180, Japan;
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
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22
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Management of Residual Hearing with Cartilage Conduction Hearing Aid after Lateral Temporal Bone Resection: Our Institutional Experience. Audiol Res 2021; 11:263-274. [PMID: 34207894 PMCID: PMC8293261 DOI: 10.3390/audiolres11020024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is no guideline for hearing compensation after temporal bone resection. This study aimed to retrospectively analyze surgical cases with reconstruction for hearing preservation after temporal bone malignancy resection and propose a new alternative to compensate for hearing loss. Methods: We retrospectively reviewed the medical records of 30 patients who underwent lateral temporal bone surgery for temporal bone malignancy at our institution and examined their hearing abilities after surgery. Result: The hearing outcomes of patients with an external auditory meatus reconstruction varied widely. The mean postoperative air–bone gap at 0.5, 1, 2, and 4 kHz ranged from 22.5 dB to 71.25 dB. On the other hand, the average difference between the aided sound field thresholds with cartilage conduction hearing aid and bone conduction thresholds at 0.5, 1, 2, and 4 kHz ranged from −3.75 to 41.25. More closely located auricular cartilage and temporal bone resulted in smaller differences between the aided sound field and bone conduction thresholds. Conclusions: There is still room for improvement of surgical techniques for reconstruction of the auditory meatus to preserve hearing after temporal bone resection. The cartilage conduction hearing aid may provide non-invasive postoperative hearing compensation after lateral temporal bone resection.
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23
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Kline NL, Bhatnagar K, Eisenman DJ, Taylor RJ. Survival outcomes of lateral skull base tumors following temporal bone resection. Head Neck 2021; 43:2414-2422. [PMID: 33851465 DOI: 10.1002/hed.26707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 03/05/2021] [Accepted: 04/01/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Lateral skull base tumors often necessitate temporal bone resection (TBR), although clinical outcomes can be unfavorable. Factors influencing survival and recurrence after TBR for cutaneous and salivary malignancies were evaluated. METHODS Twenty-six TBR subjects were included. Survival and recurrence outcomes were estimated at 1, 2, and 5 years postresection. Prognostic factors were analyzed using univariate and multivariate Cox regression. RESULTS Two years postresection, the overall survival (OS), disease-specific survival (DSS) and recurrence-free survival (RFS) rates were 61%, 74%, and 49%, respectively, and 51%, 63%, and 45% at 5 years. On univariate analysis, preoperative facial nerve dysfunction and intraoperative nerve sacrifice worsened OS, DSS, and RFS. Prior surgery and adjuvant radiation independently predicted reduced OS, DSS, and RFS on multivariate analysis. CONCLUSIONS Mortality is highest in the first 2 years following resection. Preoperative facial nerve dysfunction, facial nerve sacrifice, and prior radiation are negative predictors of survival and recurrence.
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Affiliation(s)
- Neila L Kline
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kavita Bhatnagar
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David J Eisenman
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Taylor
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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24
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Tanavde VA, Broderick J, Windon MJ, Fakhry C, Stewart CM, Eisele DW, Creighton FX. Factors and Outcomes Associated With Temporal Bone Resection for Primary Parotid Malignancy. Laryngoscope 2021; 131:E2461-E2468. [PMID: 33797071 DOI: 10.1002/lary.29547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE(S) Although parotid cancer invading into the temporal bone makes up only a small fraction of all parotid cancers, it is more common and relatively understudied compared with primary cancer of the external auditory canal. The objective of this study was to determine what factors are associated with receiving parotidectomy with temporal bone resection (TBR) and the immediate postoperative outcomes. METHODS We reviewed the National Cancer Database (2004-2015) for patients with primary parotid malignancy who received parotidectomy with or without TBR. Patient demographic, clinical, and perioperative variables were collected and then compared. Multivariate logistic regression was performed to determine factors associated with receiving TBR. RESULTS We identified 134 patients who received parotidectomy with TBR and 16,595 who received parotidectomy only. Reported in terms of odds ratios (95% confidence interval), our multivariate model showed having surgery at an academic facility (1.91 [1.34-2.71], P < .001), clinical stage III or IV (7.48 [1.65-33.96] and 31.37 [7.61-129.32], P = .009 and P < .001, respectively), histologic grade II to IV (4.36 [1.51-12.57], 4.31 [1.53-12.15], and 6.74 [2.26-20.13], P = .006, .006, and .001, respectively), and adenoid cystic histology (3.23 [2.02-5.17], P < .001) were significantly and independently associated with receiving TBR. There was no significant difference in 30-day readmission, or 30-day or 90-day mortality, but the rate of positive surgical margins was significantly higher in those who underwent TBR. CONCLUSION Demographic variables are not significant factors for receiving TBR. Tumor characteristics, such as clinical stage and histologic type, and receiving surgical treatment at an academic facility were more strongly associated with receiving TBR. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E2461-E2468, 2021.
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Affiliation(s)
- Ved A Tanavde
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Joseph Broderick
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Melina J Windon
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | | | - David W Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Francis X Creighton
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
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25
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Mahmud KA, Nasseri Z, Mohamed Mukari SA, Ismail F, Abdullah A. Aural Polyp or Temporal Bone Carcinoma: Lesson to Learn. Cureus 2021; 13:e13629. [PMID: 33816028 PMCID: PMC8011623 DOI: 10.7759/cureus.13629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Temporal bone carcinoma is a rare malignant tumor of the head and neck region. Its clinical presentations can mimic benign ear diseases, leading to inaccurate diagnosis and substandard management. We present the case of a 53-year-old female with a three-month history of progressive right otalgia, otorrhea, and hearing loss. Otoscopic examination revealed a mass occupying the right external auditory canal. However, the lesion was presumed to be an aural polyp by several clinicians previously. Multiple courses of oral antibiotics had been prescribed before she was referred to our clinic for the non-resolving aural polyp. Imaging studies showed an external auditory canal soft tissue mass with extradural and parotid extension. The mass was biopsied, and the result was reported as squamous cell carcinoma of the temporal bone. The patient was advised for a total temporal bone resection and parotidectomy; however, she declined the surgical intervention. Within a month, the tumor had metastasized to her lung, liver, and vertebral bodies. She was referred to the Oncology team for palliative chemo-radiotherapy. Temporal bone malignancy must be considered as a differential diagnosis in a middle-aged or elderly patient with a non-resolving aural polyp without a chronic discharging ear. Imaging studies and histopathological evaluation should be prompted to ascertain the diagnosis. Repeated course of oral antibiotic will delay treatment and subsequently may lead to poor prognosis.
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Affiliation(s)
- Khairil Afif Mahmud
- Department of Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Zara Nasseri
- Department of Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | | | - Fuad Ismail
- Department of Oncology and Radiotherapy, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Asma Abdullah
- Department of Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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26
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Li Y, Zuo JL, Tang JS, Shen XY, Xu SH, Xiao JL. Primary nonkeratinizing squamous cell carcinoma of the scapular bone: A case report. World J Clin Cases 2021; 9:976-982. [PMID: 33585647 PMCID: PMC7852629 DOI: 10.12998/wjcc.v9.i4.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/09/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma (SCC) of bone is usually caused by metastasis from the lungs, bladder, or other sites. Primary SCC of bone most frequently involves the skull bones, and primary involvement of other sites in the skeletal system is extremely rare. To date, only three such cases have been reported, which makes the diagnosis, treatment, and prognosis of this disease a challenge.
CASE SUMMARY A 76-year-old Chinese man presented to our hospital with nonspecific pain and limited mobility in the right shoulder for 4 mo. He underwent three-dimensional computed tomography reconstruction and magnetic resonance imaging of the right shoulder, which revealed an osteolytic destructive lesion in the right scapula with invasion into the surrounding muscles and soft tissues. Ultrasound-guided core needle biopsy detected a malignant tumor, and immunohistochemical analysis revealed a poorly differentiated SCC. Wide excision of the right scapular bone was performed, and pathological examination of the surgical specimen confirmed the diagnosis. At the last follow-up examination within 2 years, the patient was doing well with the pain significantly relieved in the right shoulder.
CONCLUSION Primary SCC of bone is extremely rare at sites other than the skull. Clinicians must exhaust all available means for the diagnosis of primary SCC of the bone, so greater attention can be paid to its timely and effective management. Regular and adequate follow-up is essential to help rule out metastasis and judge the prognosis.
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Affiliation(s)
- Yang Li
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jian-Lin Zuo
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jin-Shuo Tang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Xian-Yue Shen
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Sheng-Hao Xu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jian-Lin Xiao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
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27
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Fujita T, Kakigi A, Uehara N, Yokoi J, Hara M, Shinomiya H, Teshima M, Nibu KI. Reconstruction of the external auditory canal using full-thickness rolled-up skin graft after lateral temporal bone resection for T1 and T2 external auditory canal cancer. Auris Nasus Larynx 2021; 48:830-833. [PMID: 33454142 DOI: 10.1016/j.anl.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/26/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To present our results of the external auditory canal (EAC) reconstruction procedure using rolled-up full-thickness skin graft with tympanoplasty after lateral temporal bone resection (LTBR) for early-stage EAC carcinoma. PATIENTS AND METHODS A retrospective review of 15 patients who had undergone LTBR with reconstruction of the EAC for T1 and T2 EAC cancer between 2016 and 2020. RESULTS Postoperative mean air-bone gap was 30.7 decibel hearing level. Although a few patients experienced chronic granulation, persistent otorrhea, and/or laterization of the tympanic membrane, most patients showed no serious complications related to the EAC reconstruction. CONCLUSION EAC reconstruction using a full-thickness skin graft in combination with tympanoplasty is useful for minimizing the hearing loss, maintaining the cosmetic appearance, and facilitating the observation into the ear cavity.
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Affiliation(s)
- Takeshi Fujita
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan.
| | - Akinobu Kakigi
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
| | - Natsumi Uehara
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
| | - Jun Yokoi
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
| | - Makiko Hara
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
| | - Hirotaka Shinomiya
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
| | - Masanori Teshima
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
| | - Ken-Ichi Nibu
- Department of Otorhinolaryngology Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan
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28
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Kiyokawa Y, Ariizumi Y, Ohno K, Ito T, Kawashima Y, Tsunoda A, Kishimoto S, Asakage T, Tsutsumi T. Indications for and extent of elective neck dissection for lymph node metastasis from external auditory canal carcinoma. Auris Nasus Larynx 2020; 48:745-750. [PMID: 33386189 DOI: 10.1016/j.anl.2020.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES We aim to clarify the frequency of lymph node metastasis of external auditory canal (EAC) carcinoma, including susceptible locations, adequate extent of elective neck dissection, and the relationship between the tumor infiltration site and lymph node metastasis. PATIENTS AND METHODS From 2003 to 2018, 63 patients with EAC carcinoma at Tokyo Medical and Dental University Hospital were enrolled in this study. The T and N stages, locations of clinically positive lymph nodes, prognoses, and anatomic site of tumor infiltration were analyzed after treatment. RESULTS Clinically positive lymph node metastasis (cN+) was detected in 18 patients (28.6%), consisting of T1, T2, T3, and T4 disease in 1 (6%), 2 (22%), 8 (38%), and 7 (41%) patients, respectively. The metastatic locations were at level II in 10 patients, parotid gland nodes in 7, preauricular nodes in 5, level Ib in 3, level Va in 3, level III in 1, and superficial cervical nodes in 1. Neck recurrence was determined in two of 45 patients with clinically negative lymph nodes (cN0), with the metastatic locations being levels II, Ib, and III. Among 18 cN+ cases, neck recurrence was noted in 2 of 9 patients who underwent neck dissection. Neck lesions were found to be manageable in all five patients who underwent docetaxel, cisplatin, 5-fluorouracil, and radiation therapy (TPF-RT). No relationship was noted between the tumor infiltration site and lymph node metastasis among T3/4 canrcinoma patients. CONCLUSIONS Elective neck dissection could be indicated only in T3/4 patients with free flap reconstruction. Levels Ib to III are considered appropriate for elective neck dissection in cN0 cases. Levels Ib to III and Va indicated favorable sites, even in cases with metastasis in the parotid gland or preauricular area. Furthermore, TPF-RT could be a useful option even in cN+ cases.
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Affiliation(s)
- Yusuke Kiyokawa
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan; Department of Otolaryngology Head and Neck Surgery, Musashino Red Cross Hospital, Tokyo, Japan.
| | - Yousuke Ariizumi
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuchika Ohno
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taku Ito
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiyuki Kawashima
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsunobu Tsunoda
- Department of Otolaryngology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Seiji Kishimoto
- Department of Head and Neck Surgery, Kameda Medical Center, Kamogawa, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Tsutsumi
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
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29
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Todorovic E, Truong T, Eskander A, Lin V, Swanson D, Dickson BC, Weinreb I. Middle Ear and Temporal Bone Nonkeratinizing Squamous Cell Carcinomas With DEK-AFF2 Fusion: An Emerging Entity. Am J Surg Pathol 2020; 44:1244-1250. [PMID: 32366754 DOI: 10.1097/pas.0000000000001498] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Primary squamous cell carcinomas (SCCs) of the middle ear and temporal bone are rare and usually keratinizing by morphology. Nonkeratinizing, basaloid SCCs arising in this area are exceedingly rare, and, due to the anatomic proximity to the skull base, nasopharynx, and nasal sinuses, the differential diagnosis is broad. Most tumors with squamous differentiation arising in these subsites are either viral-induced (human papillomavirus/Epstein-Barr virus) or rarely may have specific molecular alterations (BRD4-NUT, EWSR1-FLI translocations). Occasional tumors are negative for these findings, and their pathogenesis is unknown. A recently discovered DEK-AFF2 fusion was clinically detected in a series of 2 cases known to the authors. This fusion has been previously reported in the literature in a patient with a base of skull tumor who was an exceptional responder to programmed cell death protein 1 inhibitor therapy. We examine here the histomorphologic and molecular findings of 2 additional cases of an emerging entity. Two male patients were identified. Each had a primary middle ear/temporal bone mass with locally advanced disease. The histology was reviewed, and immunohistochemistry was performed. RNA-based next-generation sequencing was performed for clinical detection of diagnostic or actionable fusions. Both patients had basaloid/nonkeratinizing tumors on biopsy. They were positive for markers of squamous differentiation (HMWK, CK5, and p40). By RNA sequencing, they demonstrated the presence of a DEK-AFF2 fusion and were negative for EWSR1 and NUT translocations. The DEK-AFF2 fusion may define a novel diagnostic category of middle ear and temporal bone nonkeratinizing/basaloid SCCs. This fusion also may represent a potential avenue for immunotherapy in these patients. Further studies are needed to fully explore whether this fusion defines a location-specific clinicopathologic entity.
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Affiliation(s)
- Emilija Todorovic
- Laboratory Medicine Program, University Health Network
- Department of Laboratory Medicine and Pathobiology, University of Toronto
| | - Tra Truong
- Department of Laboratory Medicine and Pathobiology, University of Toronto
- Departments of Pathology
| | - Antoine Eskander
- Otolaryngology/Head and Neck Surgery, Sunnybrook Health Sciences Centre
| | - Vincent Lin
- Otolaryngology/Head and Neck Surgery, Sunnybrook Health Sciences Centre
| | - David Swanson
- Department of Laboratory Medicine and Pathobiology, University of Toronto
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Brendan C Dickson
- Department of Laboratory Medicine and Pathobiology, University of Toronto
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ilan Weinreb
- Laboratory Medicine Program, University Health Network
- Department of Laboratory Medicine and Pathobiology, University of Toronto
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30
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Zanoletti E, Franz L, Cazzador D, Franchella S, Calvanese L, Nicolai P, Mazzoni A, Marioni G. Temporal bone carcinoma: Novel prognostic score based on clinical and histological features. Head Neck 2020; 42:3693-3701. [PMID: 32851728 DOI: 10.1002/hed.26435] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/02/2020] [Accepted: 08/05/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND This study aimed to develop a novel temporal bone squamous cell carcinoma (TBSCC) prognosis scoring system and compare it with the revised Pittsburgh staging system. METHODS Forty-four consecutive TBSCC patients were assessed to identify predictors of recurrence. Each predictor's hazard ratio for recurrence was used to develop our novel scoring system. RESULTS Based on variables with P < .10 in Cox's regression model, our score included: revised Pittsburgh stage; non-anterior spread of T4 carcinoma; dural involvement; and histological grade. A higher recurrence rate (P = .000) and shorter disease-free survival (P = .000) were associated with scores of ≥5. The area under the curve of our score was larger than that of the revised Pittsburgh stage for both recurrence and disease-specific mortality (P = .0178 and P = .0193, respectively). CONCLUSION Our TBSCC scoring system is based on variables that are obtainable preoperatively from clinical and radiological data and biopsies. Its prognostic value should be validated for published TBSCC series and then in prospective settings.
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Affiliation(s)
- Elisabetta Zanoletti
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Diego Cazzador
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy.,Department of Neuroscience DNS, Section of Human Anatomy, Padova University, Padova, Italy
| | - Sebastiano Franchella
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy.,Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Leonardo Calvanese
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Piero Nicolai
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Antonio Mazzoni
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
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