The Importance of Flaps in Reconstruction of Locoregionally Advanced Lateral Skull-Base Cancer Defects: A Tertiary Otorhinolaryngology Referral Centre Experience

  • Domen Vozel, M.D., Ph.D. Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia https://orcid.org/0000-0002-9992-5892
  • Peter Pukl, M.D. Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Aleš Grošelj, M.D., Ph.D. Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia https://orcid.org/0000-0002-1623-3197
  • Aleksandar Aničin, M.D., PhD. Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • prof. Primož Strojan, M.D., Ph.D. Institute of Oncology Ljubljana, Ljubljana, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia https://orcid.org/0000-0002-0445-112X
  • prof. Saba Battelino, M.D., Ph.D. Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia https://orcid.org/0000-0003-1478-0573

Abstract

OBJECTIVE: To identify the value of extensive resection and reconstruction with flaps in the treatment of locoregionally advanced lateral skull-base cancer.

METHODS: Retrospective case review of patients with lateral skull-base cancer treated surgically with curative intent between 2011 and 2019 at a tertiary otorhinolaryngology referral centre.

RESULTS: Twelve patients with locoregionally advanced cancer were analysed. Lateral temporal bone resection was performed in nine (75 %), partial parotidectomy in six (50 %), total parotidectomy in one (8.3 %), ipsilateral selective neck dissection in eight (66.7 %) and ipsilateral modified radical neck dissection in one patient (8.3 %). The defect was reconstructed with anterolateral thigh free flap (17 %), radial forearm free flap (17 %) or pectoralis major myocutaneous flap (17 %). Mean overall survival was 3.1 years (SD = 2.5) and cancer-free survival rate 100 %. At the data collection cut-off, 83 % of analysed patients and 100 % of patients with flap reconstruction were alive.

CONCLUSIONS: Favourable local control in lateral skull-base cancer, which mainly involves temporal bone is achieved with an extensive locoregional resection followed by free or regional flap reconstruction. Universal cancer registry should be considered in centres treating this rare disease to alleviate analysis and multicentric research.

KEYWORDS: Temporal Bone – Microsurgery – Parotid Region – Free Tissue Flaps – Neoplasm Staging – Ear

Published
2021-07-28
How to Cite
Vozel, D., Pukl, P., Grošelj, A., Aničin, A., Strojan, P., & Battelino, S. (2021). The Importance of Flaps in Reconstruction of Locoregionally Advanced Lateral Skull-Base Cancer Defects: A Tertiary Otorhinolaryngology Referral Centre Experience. Radiology and Oncology, 55(3), 323-332. Retrieved from https://radioloncol.com/index.php/ro/article/view/3633
Section
Clinical oncology