颞骨软骨肉瘤19例临床诊断与手术疗效分析OA

Objective To report long-term therapeutic outcomes in patients undergoing surgical management of temporal bone chondrosarcoma.Methods Clinical data of 19 patients with temporal bone chondrosarcoma treated at PLA General Hospital from August 1999 to May 2022 were retrospectively analyzed,including clinical manifestations,extent of tumor involvement,surgical approaches,and prognosis.Kaplan-Meier method was used to calculate overall survival(OS)and disease-free survival(DFS)rates.Survival curves were plotted.Results The median age of the 19 patients was 42 years(21~66 years).Common symptoms included facial paralysis and hearing loss.Diagnosis was primarily based on imaging.Individualized treatment strategies were adopted based on tumor size:12 patients underwent surgery alone,4 received surgery plus radiotherapy,2 received surgery combined with chemoradiotherapy,and 1 underwent surgery plus chemotherapy.Surgical approaches included transmastoid(n=5),cervical-transmastoid(n=5),subtotal temporal bone resection(n=4),translabyrinthine-transotic(n=1),and middle cranial fossa(n=4).Facial nerve reconstruction with great auricular nerve grafting was performed in 4 cases.Chondrosarcoma was pathologically confirmed in all cases.Two patients(10.5%)were lost to follow-up(1.8~23.5 years),and 4 experienced recurrence(22.2%,including 1 recurrence before loss to follow-up).All remaining patients survived to date.Five-year overall OS and DFS rates were 61.5%.Conclusions Temporal bone chondrosarcoma presents insidiously,and imaging combined with histopathology is essential for diagnosis.Radical surgical resection remains the cornerstone of treatment,with adjuvant radiotherapy reducing the risk of recurrence.Longitudinal surveillance beyond 10 years is critical for monitoring recurrence.