Reconstruction following temporal bone resection.

The aggressive initial treatment of external auditory canal and middle ear malignancies using ablative surgery in the form of temporal bone resection combined with postoperative curative doses (6,000 rads) of irradiation has resulted in meaningful palliation and a seeming increase in cure rates for these lesions. This combined therapy regimen has placed new demands on the wound of the temporal bone resection and subsequently necessitated development of a more substantial reconstructive effort. Hypoglossal nerve crossover has proved to be an efficient means of facial reanimation following temporal bone resection, with minimal morbidity associated with the loss of motor function to one half of the tongue. The composite posterior cervical flap, including a portion of trapezius musculature, has satisfied both the functional and cosmetic needs of this combined therapy program.