Management of Squamous Cell Carcinoma Involving the Temporal Bone

Abstract

Purpose of Review

To examine contemporary management of squamous cell carcinoma (SCC) involving the temporal bone.

Recent Findings

The modified Pittsburgh criteria have gained acceptance by many institutions for staging, planning treatment and comparing outcomes. Often primary SCC as well as secondary cutaneous SCC involving the temporal bone can be managed in a similar fashion.

Summary

T1 tumours should undergo lateral temporal bone resection (LTBR) due to the higher risk of positive margins and recurrence rates with lesser surgical procedures. T2 tumours require LTBR and superficial parotidectomy. T3 and T4 tumours often require a subtotal resection of the temporal bone (STBR), parotidectomy and cutaneous soft tissues as an en bloc excision. Advanced lesions are associated with a diminished survival especially if margins are involved. Patient outcomes are improved by a combination of surgery and postoperative radiotherapy. Preoperative imaging with high resolution CT and MRI is useful, particularly if there is evidence of large nerve perineural spread and nodal disease.

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