Temporal-Parotid Resection for Malignant Parotid Tumors: A Systematic Review.

Abstract

Surgery involving the skull base has recently gained significant prominence in treatment of head and neck cancer. "En bloc temporal-parotid resection," as applied in primary malignancies of the external ear, should be considered as a shift in the surgical landscape of "extended total parotidectomies" to achieve negative surgical margins and decrease the risk of tumor spillage during the procedure. The purpose of this systematic review is to evaluate survival outcomes and margin status in patients with parotid malignancies involving the temporal bone and treated with temporal-parotid resection (TPR). PubMed, Scopus, and Embase databases were systematically searched until 11 February 2025. The protocol of this investigation was registered on PROSPERO in February 2024 and the systematic review was performed according to the PRISMA method. The study included 336 patients from 13 articles published between 1993 and 2019. Negative surgical margins were achieved in 74.5% of cases. After a median follow-up of 32 months, 64.0% of patients achieved local disease control. Most patients (51.4%) experienced distant metastases during follow-up. Three-year overall survival (OS) and disease-specific survival (DSS) ranged between 72.4%-57.1% and 79.0%-66.7%, respectively. TPR represents a viable strategy to achieve safe oncological margins and adequate local disease control in patients with parotid gland malignancies infiltrating or abutting the temporal bone. Our findings support the growing interest in TPR, highlighting the need for further studies to refine patient selection criteria, surgical techniques, and postoperative management strategies. PROSPERO: CRD42024512013 LEVEL OF EVIDENCE: NA.