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

Ryan, John F; Hadford, Stephen P; Nellis, Jason C; Genther, Dane J; Fritz, Michael A; Byrne, Patrick J; Boahene, Kofi D O; Desai, Shaun C · Head Neck · 2026

retrospective_cohort · Level III

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Abstract

Temporal bone resection (TBR) may result in large defects and facial nerve sacrifice. Retrospective review of adults undergoing TBR from 2008 to 2019. 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). Advanced T stage and re-resection are associated with free flap reconstruction after TBR.