Lateral temporal bone resections are used in the management of locally advanced peri-auricular cutaneous squamous cell carcinomas, but there is still conflicting evidence regarding the staging, surgical and adjuvant treatment decisions.

A retrospective analysis was performed on all patients who underwent lateral temporal bone resection for cutaneous squamous cell carcinoma between January 2015 and December 2019 at a dedicated tertiary oncology referral centre.

Twenty-nine patients were included, with a median age of 77 years. Computed tomography, magnetic resonance imaging and positron emission tomography showed good diagnostic accuracy in identifying disease in the parotid gland, external auditory canal and mastoid bone, but had poor sensitivity in identifying cervical nodal metastasis. Six patients had recurrence at a median of 4.8 months post-operatively. Tumour differentiation (p = 0.0040) and post-operative radiotherapy (p = 0.0199) were associated with significantly better recurrence-free survival.

Lateral temporal bone resection for peri-auricular cutaneous squamous cell carcinoma requires careful surgical planning using clinico-radiological correlation, particularly in patients with poorly differentiated tumours.