Temporal bone resection. Review of 100 cases.

One hundred cases of temporal bone resection for cancer of the ear were reviewed retrospectively, allowing for a survival five-year follow-up period in all cases. Operative technique previously described varied from case to case but essentially involved subtotal resection of the mastoid, petrous pyramid and squamosa of the temporal bone, temporomandibular joint, base of zygoma, and attached adjacent soft tissues. The procedure sacrifices the facial nerve and hearing in the involved ear. Preoperative radiation or a sandwich technique of preoperative and postoperative radiation was used. Many complications were encountered, but with hypotensive agents, high-speed air drills, and adequate coverage of the defect, the death rate was reduced from 10% in 1954 to 5% in recent years. The overall five-year cure rate was 27%, with a 25% cure rate for squamous carcinoma.