Radical Surgery for Malignant Tumors of the Ear

Abstract

MANY YEARS have passed since the first radical surgical procedures were carried out for cancer of the ear. In 1954, Parsons and myself^1,2followed the initial efforts of Campbell et al³and carried out a one-stage intracranial-extracranial operation. Since that time some 58 procedures of this type have been performed for advanced ear cancer. The development of a combined intracranial-extracranial procedure was based on the complicated surgical anatomy of this area. The petrous pyramid lies in a venous lake comprised of lateral sinus, superior and inferior petrosal sinuses. The internal carotid system courses medially near the petrous tip. One must at once expect the sacrifice of the facial nerve. The vagus and hypoglossal nerves extend near the margins of resection at the base of the skull. The jugular bulb in its fossa has a variable position and is more liable to trauma in certain individuals. Sacrifice of an