Petrosectomies for invasive tumours: surgery and reconstruction
Tumours involving the temporal bone have historically carried a bad prognosis. The only prospect of cure is radical en bloc resection. Temporal bone resection for malignancies is, however, such a formidable undertaking that many centres label such tumours as unresectable. Additionally, the enormity...
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Published in | British journal of plastic surgery Vol. 49; no. 6; pp. 370 - 378 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Elsevier Ltd
01.09.1996
Elsevier |
Subjects | |
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Abstract | Tumours involving the temporal bone have historically carried a bad prognosis. The only prospect of cure is radical en bloc resection. Temporal bone resection for malignancies is, however, such a formidable undertaking that many centres label such tumours as unresectable. Additionally, the enormity of the surgical defect poses a major reconstructive challenge.
A review of 14 petrosectomies (in 12 males and 2 females) performed for extensively invasive neoplasms in and around the ear is presented. All underwent immediate reconstruction, the majority (12/14) with free tissue transfers. 9 of the 14 patients (64%) are still alive after a mean follow-up of 70 months (range 4–8 years). With the use of free tissue transfers, an aggressive approach with regard to the resection margins can safely be adopted in the full knowledge that the eventual size of the defect need not compromise tumour clearance. Additionally, free flaps provided a reliable dural seal. This approach of radical en bloc resection with free flap reconstruction has decreased the mortality (compared to the literature), while largely reducing the morbidity to that of unavoidable cranial nerve resection. |
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AbstractList | Tumours involving the temporal bone have historically carried a bad prognosis. The only prospect of cure is radical en bloc resection. Temporal bone resection for malignancies is, however, such a formidable undertaking that many centres label such tumours as unresectable. Additionally, the enormity of the surgical defect poses a major reconstructive challenge.
A review of 14 petrosectomies (in 12 males and 2 females) performed for extensively invasive neoplasms in and around the ear is presented. All underwent immediate reconstruction, the majority (12/14) with free tissue transfers. 9 of the 14 patients (64%) are still alive after a mean follow-up of 70 months (range 4–8 years). With the use of free tissue transfers, an aggressive approach with regard to the resection margins can safely be adopted in the full knowledge that the eventual size of the defect need not compromise tumour clearance. Additionally, free flaps provided a reliable dural seal. This approach of radical en bloc resection with free flap reconstruction has decreased the mortality (compared to the literature), while largely reducing the morbidity to that of unavoidable cranial nerve resection. Tumours involving the temporal bone have historically carried a bad prognosis. The only prospect of cure is radical en bloc resection. Temporal bone resection for malignancies is, however, such a formidable undertaking that many centres label such tumours as unresectable. Additionally, the enormity of the surgical defect poses a major reconstructive challenge. A review of 14 petrosectomies (in 12 males and 2 females) performed for extensively invasive neoplasms in and around the ear is presented. All underwent immediate reconstruction, the majority (12/14) with free tissue transfers. 9 of the 14 patients (64%) are still alive after a mean follow-up of 70 months (range 4-8 years). With the use of free tissue transfers, an aggressive approach with regard to the resection margins can safely be adopted in the full knowledge that the eventual size of the defect need not compromise tumour clearance. Additionally, free flaps provided a reliable dural seal. This approach of radical en bloc resection with free flap reconstruction has decreased the mortality (compared to the literature), while largely reducing the morbidity to that of unavoidable cranial nerve resection. |
Author | Batchelor, Gerry G.G. Malata, C.M. Cooter, Rodney D. Towns, Gerry M. |
Author_xml | – sequence: 1 givenname: C.M. surname: Malata fullname: Malata, C.M. organization: Department of Plastic, Reconstructive and Hand Surgery, St James's University Hospital, Leeds, UK – sequence: 2 givenname: Rodney D. surname: Cooter fullname: Cooter, Rodney D. organization: Department of Plastic, Reconstructive and Hand Surgery, St James's University Hospital, Leeds, UK – sequence: 3 givenname: Gerry M. surname: Towns fullname: Towns, Gerry M. organization: Department of Neurosurgery, Pinderfields Hospital, Wakefield, West Yorkshire, UK – sequence: 4 givenname: Gerry G.G. surname: Batchelor fullname: Batchelor, Gerry G.G. organization: Department of Plastic, Reconstructive and Hand Surgery, St James's University Hospital, Leeds, UK |
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Keywords | Human Petrous bone Temporal bone Stomatology Treatment efficiency Mortality Bibliographic survey Male Anatomical reconstruction Radiotherapy Ablation Morbidity Retrospective Result Case study Surgery Free flap Adult Complication Female Technique Comparative study |
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Snippet | Tumours involving the temporal bone have historically carried a bad prognosis. The only prospect of cure is radical en bloc resection. Temporal bone resection... |
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SubjectTerms | Adult Aged Aged, 80 and over Biological and medical sciences Ear - pathology Female Follow-Up Studies Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Humans Male Maxillofacial surgery. Dental surgery. Orthodontics Medical sciences Middle Aged Neoplasm Invasiveness Petrous Bone - surgery Postoperative Complications Retrospective Studies Skull Neoplasms - pathology Skull Neoplasms - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery, Plastic - methods Surgical Flaps |
Title | Petrosectomies for invasive tumours: surgery and reconstruction |
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