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Video

Otology/Neurotology

(A847) Outcomes and Risk Factors in Oncologic Temporal Bone Surgery: A Head and Neck-Specific NSQIP Study

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • BD

    Bailey H. Duhon, MS

    Medical Student
    University of Texas Health Science Center At Houston
    Houston, Texas, United States

    • Co-Author(s)

  • XS

    Xiaowen Sun, MS

    The University of Texas MD Anderson Cancer Center, United States

  • MH

    Mike Hernandez, MS

    The University of Texas MD Anderson Cancer Center, United States

  • Carol M. Lewis, MD

    Professor
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

  • Marc-Elie Nader, MD

    Associate Professor
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    • Senior Author(s)

  • PG

    Paul W. Gidley, MD

    Professor
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

Disclosure(s):
Bailey H. Duhon, MS: No relevant relationships to disclose.
Carol M. Lewis, MD: No relevant relationships to disclose.
Marc-Elie Nader, MD: No relevant relationships to disclose.
Paul W. Gidley, MD: No relevant relationships to disclose.


Introduction: Advanced temporal bone and parotid gland malignancies are rare and difficult to manage, often requiring otologic approaches. However, complications of oncologic temporal bone surgery have not been systematically categorized. We aim to detail the postoperative outcomes of lateral temporal bone resection (LTBR) and mastoidectomy for otologic oncology patients, and secondarily, to identify preoperative risk factors.

Methods: Retrospective review (2012-2019) of patients with temporal bone or parotid gland malignancies treated with LTBR or mastoidectomy at our institution. Demographic, clinical, and 30-day postoperative data was extracted from a head and neck-specific (HNS) NSQIP database.

Results: A total of 174 patients underwent LTBR (N=121) or mastoidectomy (N=53). Of them, 53% had advanced (T3/T4) malignancy. Reconstructive procedures were performed in 98%, with 94% being free flaps.

Half of all patients experienced at least one post-operative occurrence (N = 59/121, LTBR; N=27/54, mastoidectomy), the most common being anemia requiring blood transfusion (N=47/174). Mastoidectomy had a higher risk of facial nerve injury compared to LTBR (21% v. 2%, p< 0.01), consistent with its use in advanced parotid malignancy. LTBR patients had a longer length of stay (LOS) (8 v. 6 days, p< 0.01). Only 8 patients developed surgical site infections, and the 30-day mortality was 0.

Multivariate analysis showed that increased age (OR 1.5, 95% CI: 1.1-2.0, p=0.01), large tumors (T3/T4) (OR 2.8, 95% CI: 1.0-7.7, p< 0.05), and operative time over 13 hours (OR: 2.4, 95% CI: 1.2-5.0, p=0.02) significantly increased the odds of developing an HNS-NSQIP occurrence. The LOS was most correlated with operative times (Rho=0.25, p< 0.01), but age, frailty score (mFI-5), and tumor stage were also statistically significant (p < 0.05).

Conclusions: LTBR and mastoidectomy, alongside their reconstruction, are associated with relatively high rates for anemia requiring blood transfusion, new-onset facial paralysis, and extended LOS. When performing risk assessment and mitigation, frailty, age, and tumor stage should be considered.