XXXX of the external ear canal and temporal bone: surgical techniques and results.

@entity1 @entity2172 @entity66 @entity2167 @entity3975 @entity5 @entity2347 @entity957 @entity2968 @entity3981 @entity1491
A combined therapy approach to @entity2167 and middle ear has been developed. A technique of external canal resection and gross @entity5 removal from the middle ear, parotid gland, and superior cervical lymph nodes is followed by postoperative full-therapy irradiation. This combined approach has been used in 30 @entity1 with @entity5 involving the external auditory canal and temporal bone. The preoperative evaluation and surgical technique, including the intraoperative decision-making process, is described. Twenty-four @entity1 had @entity957 of the external auditory canal, and two @entity1 had @entity1491 . There was one @entity1 each with @entity2347 , @entity3981 , high grade @entity3975 , and a @entity2968 . This group of @entity1 was broken down into three groups based on the extent of disease as determined at surgery. Overall control of disease, both locally and distant, for the 30 @entity1 was 66%. There were 12 @entity1 with disease limited to the ear canal. These @entity1 had a 91% survival of this disease process. Seven @entity1 were determined to have limited extension beyond the ear canal. These were treated with combined therapy with an overall control of disease of 72%. Eleven @entity1 had @entity66 outside of middle ear into the carotid jugular spine, stylomastoid foramen, and skull base, with a survival rate of 45%. It is concluded that a step-wise removal of all gross @entity5 , as opposed to an en bloc dissection of the temporal bone and skull base, followed by full-therapy irradiation gives equally as good, or even better, long-term survival for this @entity2172 .
