Squamous Cell Carcinoma of the Temporal Bone: Results and Management

Introduction: The incidence of squamous cell carcinoma of the external auditory canal is extremely low and is estimated to be ∼1–5 cases per million population. This malignancy is characterized by an aggressive behavior with a consequently high mortality rate. We evaluate the management and survival of our patients treated for temporal bone squamous cell carcinoma. In addition, we provide a treatment protocol. Methods: A retrospective analysis was performed of 28 patients who underwent primary treatment for squamous cell carcinoma of the temporal bone. The patients were staged using the modified Pittsburgh staging system. Patients underwent a local resection, lateral temporal bone resection, or a subtotal lateral temporal bone resection usually followed by radiotherapy. Survival of patients, grouped by tumor size, was calculated. Results: Staging revealed 12 pT1, 2 pT2, 4 pT3 and 10 pT4 tumors. The mean follow-up was 34 months (range, 2–132 months). The Kaplan-Meier survival curves showed survival rates at 5 years of 83% and 25%, respectively, for the stages pT1 and pT4. The pooled survival curves showed survival rates at 5 years of 85% and 46%, respectively, for the stages pT1/pT2 and pT3/pT4. Conclusions: Long-term prognosis of the carcinoma of the external auditory canal mainly depends on the stage and primary treatment. Surgery may consist of a lateral temporal bone or subtotal temporal bone resection; in T3 and T4 tumors resection may be combined with a superficial parotidectomy. If disease is diagnosed in the neck or parotid then a neck dissection and total parotidectomy may also be performed. Additional radiotherapy should be given in incompletely resected T1 tumors, all T2 and T3 tumors, and part of the T4 tumors. T4 tumors may be treated according to their subclassification based on the anatomical extension.