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.