Surgical management outcomes of osteoradionecrosis of the temporal bone: two-centres experience.

PURPOSE: Temporal bone osteoradionecrosis (ORN) is a severe complication that can occur when the temporal bone lies within the field of radiation therapy (RT), mainly for head and neck cancer. Currently, there is no universally accepted treatment approach, but both conservative and surgical management options have been proposed. We present the outcomes of surgically treated cases and propose our surgical strategy for complete management.

METHODS

A retrospective study was conducted to identify temporal bone ORN cases that were primarily treated surgically at two centres between 2005 and January 2025. We recorded and analysed patients' demographics, the anatomic site of the primary tumors and assessed hearing and other postoperative outcomes.

RESULTS

Fourteen cases of ORN of the temporal bone have been identified. Management for these cases varied: six were treated with canaloplasty, two had mastoidectomy with reconstruction, three had lateral temporal bone resection with blind sac closure, three were treated with petrosectomy and blind sac closure. The mean age at diagnosis was 63 years, and half of the cases involved males. The most common site of the primary tumor that received RT was the nasopharynx.

CONCLUSION

Surgery is an effective management option for recalcitrant temporal bone ORN. The surgical strategy for temporal bone ORN is guided by disease extent and hearing status. As there are no standardised recommendations for its management, future research is necessary.