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tumour is small and limited to the soft tissue of the external auditory canal. For more invasive tumours a lateral temporal bone resection is needed. A lateral temporal bone resection involves resection of the bony external auditory canal, the typmpanic membrane malleus, incus and medial limit at the level of the incudostapedial joint. Stage I & II disease usually undergo lateral temporal bone resection, superficial parotidectomy and selective neck dissection. Stage III or IV undergo lateral temporal bone resection with parotidectomy, neck dissection and post-operative adjuvant radiotherapy. There are limited studies on temporal bone malignancies due to their rarity. There are currently only 9 studies reporting more than 35 cases. Our overall survival rates are comparable with these studies but there as a significant difference in our disease free survival. The main difference between the studies is in our higher rate of patients presenting with recurrence. We had over 50% of patients presenting to us with recurrence at the site of previous excision compared to only 20% of the patients in other studies. We need to ensure that patients are treated aggressively at initial presentation for these malignancies.Reference 1 Gidley PW, Roberts DB, Sturgis EM. Squamous cell carcinoma of the temporal bone.

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Original Research ArticleIntroduction: The reconstruction of defects in the foot and ankle is a real challenge for plastic surgeons. Material and methods: A retrospective study of a series made up of 18 patients who benefited, in the plastic surgery department of the Mohamed V Military Hospital in Rabat, from January 2015 to December 31, 2018, of a reconstruction of ankle skin substance loss and of the neck of the foot by a sural neurocutaneous flap with distal pedicle, using a fascio-fatty strip containing the pedicle more than 3cm. while specifying the inclusion and exclusion criteria. Results: We noticed, a male predominance. The average age is 41.6 years old. The coverage interested the internal malleolus in ten cases, the external malleolus in seven cases, and the instep for 3 patients. Ten out of eighteen patients benefited from an intervention in two surgical times, covering the skin defect by the flap with a large pedicle and skin graft of the donor area secondarily. Minimal and manageable complications were noticed. Discussion: Anatomical reminder and the details of our technique, it is a reliable means for covering defects in the instep and ankle, a comparison was made with other plastic surgery procedures. Advantages and disadvantages of our technique; all stressing the need to take a pedicle wide more than three centimeters. Conclusion: A technique of choice for covering losses of substance in the ankle and the instep. The aim of this study was to report our experience and to assess the reliability of this flap by taking a large pedicle.

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