Auricular complications following temporal bone resection for temporal
bone malignancies: a clinical consideration
Abstract
Abstract: Objective: Sacrificing the auricle has severe postoperative
impacts on patients with temporal bone malignancy who have undergone en
bloc temporal bone resection. The auricular complications following en
bloc temporal bone resection remain unclear. Therefore, this study aimed
to examine auricular complications following en bloc temporal bone
resection and reveal the associated risk factors. Study Design: Case
series with chart review. Setting: Single tertiary care medical center
Participants: Our study includes all cases who underwent en bloc
temporal bone resection with preserved auricle for temporal bone
malignancy from January 1993 to July 2020. The resulting dataset
contained 64 patients during the review period. Main outcome measures:
We examined the relationship of auricular complications with surgical
procedures and patient profiles. Results: Three of 64 cases (4.7%)
showed postoperative auricular complication. The cause in all three
cases was venous congestion. Postoperative bloodletting to relieve the
congestion effectively salvaged the auricle in two of these cases.
Insufficient bloodletting to relieve the auricular congestion in the
remaining case led to auricular necrosis. Pre-/infra-auricular lymph
node dissection is correlated with auricular complications with
statistical significance. Conclusions: Temporal bone resection causes
auricular congestion due to vascular insufficiency, particularly
insufficient venous outflow. An immediate and continuous application of
bloodletting can improve venous drainage after temporal bone resection
to prevent auricle necrosis.