The oncology of otology

Abstract

Otologic surgery plays an important role in managing cancers that involve the ear canal, temporal bone, or lateral skull base. The specialty of otologic oncology is emerging as a defined area of practice.

Temporal bone carcinoma: Classical prognostic variables revisited and modern clinico-pathological evidence

“…The radicality achieved with extensive surgery is the most important independent factor influencing prognosis [10][11][12][13][14][15][16] though it is not clear how surgical margins can be really considered "free" in the bone. 10 The en-bloc resections with lateral or subtotal temporal bone resections (LTBR and STBR), though more likely to ensure gross radicality, encounter the problem of microscopic diffusion in the bone and may explain the relatively high recurrence rate also after surgery with pathologically free margins.…”

“…The pathological status of surgical margins was diffusely reported as the main factor influencing the outcome and the recurrence rate, [10][11][12][13][14][15][16] although how reliable "free margins" could be in the bone is still a matter of discussion. 10 There is quite a general agreement on the significant role of T stage according to the Pittsburgh staging system 10,12,13,15,16 as a factor determining prognosis, since the latter was good in T1-T2 and poor in T3-T4.…”

“…Extensive erosion of the bone was also a negative prognostic factor. 11,13,16,17 The pathological grading of the tumor was reported as a factor related to worse prognosis only in a limited number of series. 10,18 In part, facial nerve involvement continues to be controversial with a significant negative prognostic role found by most 11,12,15,16,[19][20][21][22] but not all groups.…”

“…10,18 In part, facial nerve involvement continues to be controversial with a significant negative prognostic role found by most 11,12,15,16,[19][20][21][22] but not all groups. 23 Dura mater infiltration evidence (both radiological and/or pathological) was reported in most of the series 10,11,21,22 as the strongest negative prognostic factor affecting survival.…”

Rhabdomyosarcoma and Other Pediatric Temporal Bone Malignancies

“…1,2 Classically, these tumors mimic a severe and refractory ear infection. The most common presenting symptoms and signs are hearing loss, otorrhea, otalgia, headache, aural polyp, facial nerve weakness, and regional lymphadenopathy.…”