AHNS
Justin M. Hintze, MD MB BCh MSc MA
Specialist Registrar
Beaumont Hospital, Dublin, Ireland
Dublin, Dublin, Ireland
All patients underwent a LTBR, while 68.4% (n=26) underwent a pinnectomy, 71.1% (n=27) had a parotidectomy and 65.8% (n=25) had a neck dissection (44% of which were modified radical). Level 1 was positive in 2.6%, level 2 in 15.8%, level 3 in 7.9%, level 4 in 7.9% and level 5 in 5.3%. The parotid had disease in 34.2% (n=13), of which 54% was due to direct invasion. 59% of patients underwent free flap reconstruction. Pathological size of the main specimen did not influence the rate of nodal disease, however depth of the specimen did (p=0.117 and 0.009 respectively). Mean overall survival of the cohort was 4 years, while mean disease specific survival was 5.3 years. There was no statistical significant difference in survival based on nodal disease or parotid disease.
Conclusions: In the present study the rate of cervical nodal metastasis was 21%, with the most common location for nodal metastasis in level 2. The parotid was involved in in 34% of cases. Due to the high rate of parotid disease, results from the present support consideration for performing a parotidectomy at the time of lateral temporal bone resection, while a neck dissection can be performed for adequate staging of the nodal basin as well as during dissection of vessels for microvascular reconstruction.