Management of the temporal bone defect after resection of external auditory canal cancer |
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| Institution: | 1. Department of Otorhinolaryngology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan;2. Department of Plastic Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan;3. Department of Neurosurgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan;4. Department of Head and Neck Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan;1. Department of Clinical Laboratory, Yokohama Brain and Spine Center, Yokohama, Japan;2. Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan;1. Divisions of Gastroenterology, Ise Red Cross Hospital, 471-2, 1, Funae, Ise, Mie 516-8512, Japan;2. Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan;3. Divisions of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan;1. Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena Italy;2. Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy;1. Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan;2. Department of Otorhinolaryngology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan;3. Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan;4. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan;1. Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan;2. Department of Public Health Research, Kurashiki Clinical Research Institute, Kurashiki, Japan |
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| Abstract: | ObjectiveTo evaluate the surgical procedures used to treat external auditory canal cancer with respect to avoiding postoperative infection of the temporal bone defect.MethodsEnrolled in the study were 52 patients with external auditory canal cancer surgically treated between July 2015 and October 2020 (38 lateral temporal bone resections, 12 subtotal temporal bone resections and 2 partial resections, accompanied by various combined procedures). Retrospective chart review was conducted taking into consideration postoperative infection, and univariate analysis of prognostic factors was performed.ResultsIn cases managed with subtotal temporal bone resection, no postoperative infections occurred. Cases managed with subtotal temporal bone resection demonstrated increased use of free-flap reconstruction, and longer antibiotic infusion period. On the other hand, analysis of cases managed with lateral temporal bone resection revealed 10 out of 38 patients with postoperative infection (26.3%). However, we couldn't find out any factors that contributed significantly to the prevention of postoperative infection, including the surgical procedures used to manage the defected space, which included free-flap implantation, obliteration with fat tissue, muscular flap rotation, and leaving the space empty without obliteration or reconstruction.ConclusionIn cases managed with lateral temporal bone resection, leaving the resected space empty did not increase the risk of infection. On the other hand, in cases with subtotal temporal bone resection, filling the surgical defect with an autologous bulk, including the free-flap reconstruction and fat obliteration, seems to prevent the infection. Moreover, prolonged antibiotic infusion may suppress postoperative infection of the temporal bone defect. |
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