Abstract
Temporal bone malignancies are challenging as the pathologies are heterogeneous and risk stratification is difficult. Depending on the histology, they have the ability for aggressive local invasion and regional metastases. Similarly, primary parotid, parapharyngeal, or cutaneous malignancies may result in temporal bone invasion via local or regional extension. Appropriate work-up including a full history, physical examination, imaging, and pathology review is critical to the primary location and tumor extent. This allows a better understanding for the potential sites of metastasis in the parotid and neck. Several factors must be taken into account when deciding on the role of parotidectomy and neck dissection, specifically, histology, stage, location, and extent of the primary tumor invasion and the need for reconstructive surgery. Parotidectomy is indicated for direct tumor invasion or if the parotid is within the draining nodal basin. Indication for neck dissection is clinically evident nodal disease. Elective neck dissection is based on the risk of metastasis. In the setting of temporal bone malignancy, the risk for nodal metastasis across all pathologies is 13–34%. We advocate elective neck dissection for advanced-stage tumors when at least a 20% risk of metastatic spread exists. Nodal levels dissected are based on the location of the primary. Overall parotidectomy and neck dissection are safe surgeries but convey risks that must be discussed with the patient.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Gidley PW, et al. The oncology of otology. Laryngoscope. 2012;122(2):393–400.
Arriaga M, et al. Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings. Ann Otol Rhinol Laryngol. 1990;99(9 Pt 1):714–21.
Mazzoni A, Danesi G, Zanoletti E. Primary squamous cell carcinoma of the external auditory canal: surgical treatment and long-term outcomes. Acta Otorhinolaryngol Ital. 2014;34(2):129–37.
Tozoglu U, Caglayan F, Harorli A. Foramen tympanicum or foramen of Huschke: anatomical cone beam CT study. Dentomaxillofac Radiol. 2012;41(4):294–7.
Lacout A, et al. Foramen tympanicum, or foramen of Huschke: pathologic cases and anatomic CT study. AJNR Am J Neuroradiol. 2005;26(6):1317–23.
Rouvière H, Tobias MJ. Anatomy of the human lymphatic system. Ann Arbor: Edwards Brothers; 1938.
Peach HS, et al. The unpredictability of lymphatic drainage from the ear in melanoma patients, and its implications for management. Ann Surg Oncol. 2013;20(5):1707–13.
Stell PM. Carcinoma of the external auditory meatus and middle ear. Clin Otolaryngol Allied Sci. 1984;9(5):281–99.
Rinaldo A, et al. Nodal disease in temporal bone squamous carcinoma. Acta Otolaryngol. 2005;125(1):5–8.
Piccirillo JF. Importance of comorbidity in head and neck cancer. Laryngoscope. 2000;110(4):593–602.
Piccirillo JF, Costas I. The impact of comorbidity on outcomes. ORL J Otorhinolaryngol Relat Spec. 2004;66(4):180–5.
Piccirillo JF, et al. Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA. 2004;291(20):2441–7.
Gidley PW, et al. The results of temporal bone surgery for advanced or recurrent tumors of the parotid gland. Laryngoscope. 2011;121(8):1702–7.
Lai SY, et al. Parotidectomy in the treatment of aggressive cutaneous malignancies. Arch Otolaryngol Head Neck Surg. 2002;128(5):521–6.
Gidley PW, DeMonte F. Temporal bone malignancies. Neurosurg Clin N Am. 2013;24(1):97–110.
Lee YY, et al. Imaging of salivary gland tumours. Eur J Radiol. 2008;66(3):419–36.
McGuirt WF, et al. A comparative diagnostic study of head and neck nodal metastases using positron emission tomography. Laryngoscope. 1995;105(4 Pt 1):373–5.
Kendi AT, et al. Is there a role for PET/CT parameters to characterize benign, malignant, and metastatic parotid tumors? AJR Am J Roentgenol. 2016;207(3):635–40.
Committee AASC ACR–ASNR–SPR practice parameter for the performance of computed tomography (CT) of the extracranial head and neck. 2016.
Witt BL, Schmidt RL. Ultrasound-guided core needle biopsy of salivary gland lesions: a systematic review and meta-analysis. Laryngoscope. 2014;124(3):695–700.
Douville NJ, Bradford CR. Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck. 2013;35(11):1657–61.
Morris LG, et al. Predictors of survival and recurrence after temporal bone resection for cancer. Head Neck. 2012;34(9):1231–9.
O’Connor A, et al. Evaluating the outcomes of temporal bone resection in metastatic cutaneous head and neck malignancies: 13-year review. J Laryngol Otol. 2015;129(10):964–9.
Dean NR, et al. Outcomes following temporal bone resection. Laryngoscope. 2010;120(8):1516–22.
Carlson ML, et al. Occult temporal bone facial nerve involvement by parotid malignancies with perineural spread. Otolaryngol Head Neck Surg. 2015;153(3):385–91.
Hanasono MM, et al. Comprehensive management of temporal bone defects after oncologic resection. Laryngoscope. 2012;122(12):2663–9.
Hanasono MM, et al. Adipofascial perforator flaps for “aesthetic” head and neck reconstruction. Head Neck. 2011;33(10):1513–9.
Yin M, et al. Analysis of 95 cases of squamous cell carcinoma of the external and middle ear. Auris Nasus Larynx. 2006;33(3):251–7.
Mehra S, et al. Outcomes of temporal bone resection for locally advanced parotid cancer. Skull Base. 2011;21(6):389–96.
Zanoletti E, Danesi G. The problem of nodal disease in squamous cell carcinoma of the temporal bone. Acta Otolaryngol. 2010;130(8):913–6.
Ali S, et al. Treatment of the neck in carcinoma of the parotid gland. Ann Surg Oncol. 2014;21(9):3042–8.
Pathak I, et al. Do nodal metastases from cutaneous melanoma of the head and neck follow a clinically predictable pattern? Head Neck. 2001;23(9):785–90.
Erman AB, et al. Sentinel lymph node biopsy is accurate and prognostic in head and neck melanoma. Cancer. 2012;118(4):1040–7.
Olsen KD, Moore EJ, Lewis JE. Frozen section pathology for decision making in parotid surgery. JAMA Otolaryngol Head Neck Surg. 2013;139(12):1275–8.
Terrell JE, et al. Clinical outcome of continuous facial nerve monitoring during primary parotidectomy. Arch Otolaryngol Head Neck Surg. 1997;123(10):1081–7.
Shuman AG, Bradford CR. Ethics of Frey syndrome: ensuring that consent is truly informed. Head Neck. 2010;32(8):1125–8.
Chen YJ, et al. Carotid blowout in patients with head and neck cancer: associated factors and treatment outcomes. Head Neck. 2015;37(2):265–72.
Powitzky R, et al. Carotid blowout in patients with head and neck cancer. Ann Otol Rhinol Laryngol. 2010;119(7):476–84.
Chan M, et al. Imaging of auriculotemporal nerve perineural spread. Ecancermedicalscience. 2013;7:374.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Chinn, S.B., Weber, R.S. (2018). Parotidectomy and Neck Dissection for Temporal Bone Malignancy. In: Gidley, P., DeMonte, F. (eds) Temporal Bone Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-74539-8_22
Download citation
DOI: https://doi.org/10.1007/978-3-319-74539-8_22
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74538-1
Online ISBN: 978-3-319-74539-8
eBook Packages: MedicineMedicine (R0)