Reconstruction and Facial Reanimation After Temporal Bone Resection: A Multi-Institution Experience.

BACKGROUND

Temporal bone resection (TBR) may result in large defects and facial nerve sacrifice.

METHODS

Retrospective review of adults undergoing TBR from 2008 to 2019.

RESULTS

One hundred and forty patients were reviewed. The extent of TBR was lateral (n = 135), subtotal (n = 2), and total (n = 3). Defects were reconstructed with free flaps (n = 72), regional flaps (n = 45), and cervicofacial flaps (n = 31). Complications included wound dehiscence (n = 20), infection (n = 15), hematoma (n = 6), cerebrospinal fluid leak (n = 2), and meningitis (n = 1). Smoking history was associated with wound complications (OR = 1.23, p = 0.03). Prior resection (OR = 2.34, p = 0.03) and advanced T stage (OR = 1.38, p = 0.04) were associated with free flap reconstruction. Forty-seven patients underwent facial nerve sacrifice. Facial reanimation techniques included primary neurorrhaphy (n = 2), interposition nerve grafting (n = 28), masseteric (n = 7), or hypoglossal (n = 5) to nerve transfers, temporalis tendon transfer (n = 21), ectropion repair (n = 31), brow lift (n = 21), and upper eyelid loading (n = 40).

CONCLUSION

Advanced T stage and re-resection are associated with free flap reconstruction after TBR.