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34% in patients with mild facial paralysis, 50% with
moderate paralysis, and 62% with complete paralysis
[17,18]. In our cases, facial paralysis was noted in nine
patients, seven of whom died of carcinoma. As pointed
out by Varyberg and Sataloff [7], treatment failure was
mostly due to local recurrence. To improve the survival
rate, initial surgery should be aggressive, as it offers the
greatest chance for cure [19], and survival is reported to
be better with more extensive surgery [20]. This is tech-
nically difficult, as the temporal bone locates closely to
vital structures such as the brain, brainstem, cranial
nerves and major vessels. In conclusion, external and
middle ear carcinoma is curable when detected at an ear-
ly stage. In cases extending deep into the middle ear or
occurring in the middle ear cavity, prognosis is poor even
with combination treatment with surgery plus chemora-
diotherapy. Improving the survival rate in temporal bone
carcinoma requires that treatment is started at an early
stage.
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