Total temporal bone resection for squamous cell carcinoma.

Because of unsatisfactory results in treatment of malignant conditions of the temporal bone, a technique for total en bloc resection of the temporal bone and carotid artery was reported by Graham et al. in 1984. The procedure involves resection of the internal carotid artery, cranial nerves VI through XII, and structures adjacent to the temporal bone. Experience with two additional cases led to numerous modifications in the recommended procedure, as reported by Sataloff and Myers. Additional clinical experience with this technique and its complications has resulted in further modification. Additional pitfalls and specific changes in technique from previous reports are discussed in detail, including a new procedure to assure the adequacy of contralateral venous outflow.