Temporal bone and lateral skull base malignancy: experience and results with 81 patients.

OBJECTIVE

This study aimed to examine predictive factors and treatment outcome and to devise a staging method for malignant lateral skull base disease.

STUDY DESIGN

The study design was a retrospective review of all lateral skull base surgery cases.

SETTING

The study was conducted at a tertiary referral center.

PATIENTS

Of 317 lateral skull base lesions, 81 patients were found to have malignant disease. Three groups were identified, and the data were analyzed according to the following: epithelial malignancies, 30 patients; malignancies of salivary gland origin, 23 patients; and malignancies of mesenchymal origin, 28 patients. The mean age was 48.5 years with a range of 5-83 years. There were 42 males and 39 females. Our mean follow-up time was 54 months with a range of 1-180 months. Forty-three patients were alive without evidence of recurrent disease, 6 were living with disease, 25 were dead of disease, 3 died of other causes, and 4 were lost to follow-up.

INTERVENTIONS

All patients underwent surgery with curative intent. Forty-two received adjuvant radiation, and 8 received chemotherapy.

MAIN OUTCOME MEASURES

Treatment failure, survival, cranial nerve deficits, complications, and predictive factors were analyzed.

RESULTS

A 58% treatment success rate was observed. Epithelial and salivary malignancy had a poorer prognosis, and pain and facial nerve dysfunction at presentation carried a worse prognosis.

CONCLUSIONS

Lateral skull base malignancy is a rare entity that continues to challenge cranial base surgeons. Cranial nerve deficits and complications are frequent. The success rate of treatment is dependent on histology and disease extent.