Malignant external auditory canal and temporal bone tumours: Clinical outcomes in Cape Town, South Africa.

Background: Temporal bone cancers are associated with high morbidity and poor prognosis. However, no established treatment guidelines currently exist. Information on temporal bone carcinomas in sub-Saharan Africa is almost non-existent in the literature. The aim of the study was to look at the outcomes of temporal bone malignancies in a developing-world setting. Methods: A retrospective chart review was conducted at a tertiary-care hospital in Cape Town, South Africa, of all patients with newly diagnosed temporal bone malignancies from 2008 to 2023. Distant metastases to the temporal bone were excluded. Results: In total, 20 patients were identified, with a mean age of 60.7 years. From the study sample, 40% of the patients were male, and 60% were female. The most common histological diagnosis was squamous cell carcinoma (70%), followed by adenoid cystic carcinoma (15%). Seventy per cent of patients were treated with curative intent; 65% with primary surgery and 5% with primary radiotherapy, respectively. The remaining patients were offered palliative radiotherapy (25%) and best supportive care (5%). Disease recurrence occurred in 25% of patients, with the mean time to recurrence being 5.6 months. The mean overall survival for the cohort was 1.52 ± 1.23 years, while the mean disease-specific survival was 1.68 ± 1.67 years. Conclusion: Early diagnosis of temporal bone cancers is fundamental, and aggressive resection is essential, if indicated, to obtain negative margins and minimise recurrence. Contribution: This study provides valuable insights into temporal cancers in sub-Saharan Africa and paves the way for larger studies on the continent.