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Evaluation and Staging of Temporal Bone Tumors

  • Joseph T. Breen
  • Paul W. Gidley
Chapter

Abstract

An accurate and complete clinical evaluation is mandatory for proper decision-making in managing temporal bone cancer. Presenting symptoms, medical and surgical history, physical examination, imaging, and adjunctive testing are all used to determine the extent and stage of the tumor. Comprehensive knowledge of temporal bone anatomy and physiology and understanding of auditory and vestibular testing are crucial for proper patient evaluation.

There is no universally adopted staging system for temporal bone cancer. Staging attempts to stratify patients by odds of survival, guide treatment, and provide a framework for reporting outcomes.

There are significant functional consequences of aggressive treatment, but survival is poor when attempting salvage treatment for recurrent disease. An appropriate balance between these opposing realities will minimize risk of recurrence while avoiding excessive treatment-related morbidity. This needs to start with precise localization and characterization of the disease process.

Keywords

Physical examination Head and neck examination Cranial nerve examination Staging Temporal bone cancer Ear canal cancer Oto-endoscopy Audiometry 

Abbreviations

AJCC

American Joint Committee on Cancer

BPPV

benign paroxysmal positional vertigo

CT

computed tomography

cVEMP

cervical vestibular-evoked myogenic potentials

EAC

external auditory canal

ENG

electronystagmography

ENoG

electroneuronography

MRI

magnetic resonance imaging

oVEMP

ocular vestibular-evoked myogenic potentials

PSS

Pittsburgh staging system

SCC

squamous cell carcinoma

TM

tympanic membrane

TNM

tumor node metastasis

VEMP

vestibular-evoked myogenic potentials

VNG

videonystagmography

VOR

vestibular-ocular reflex

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Joseph T. Breen
    • 1
  • Paul W. Gidley
    • 2
  1. 1.CincinnatiUSA
  2. 2.Department of Head and Neck SurgeryThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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