Background: Subtotal temporal bone resection (STBR) has been utilized for half a century to remove temporal bone malignancies. However, there are few reports on the detailed anatomy involved in the resection.
Objective: This study focuses on the microsurgical anatomy of STBR combined en bloc with the resection of the parotid gland and temporomandibular joint (TMJ).
Methods: Cadaveric specimens were dissected in a stepwise manner using 3 – 40X magnification.
Results: STBR can be combined with the total parotidectomy and the resection of the TMJ if the tumor extends into the parotid gland, TMJ, or facial nerve. In this study, we described the step by step microsurgical anatomy of STBR en bloc with the parotid gland and TMJ. The surgical technique described combines three approaches: high cervical, subtemporal-infratemporal fossa, and retromastoid-paracondylar approaches. Combining these three approaches aided in efficiently completing this modified approach.
Conclusion: STBR is a complicated and technically challenging procedure. This study highlights the importance of understanding the surgical anatomy of STBR and will serve as a catalyst for improvement of the surgical technique for temporal bone resection.
From: Microsurgical Anatomy of Subtotal Temporal Bone Resection En Bloc With the Parotid Gland and Temporomandibular Joint by Komune et al.