Literature search
The literature review yielded 1034 articles. From the review of the titles and abstracts, 1008 articles were excluded for being irrelevant to the topic, non-English language, non-original, case reports, editorials or duplicated studies (Figure 1). Twenty-six full-text articles were examined reporting elective neck dissection in the therapeutic management of cN0 in squamous cell carcinoma of the temporal bone. Of these, 17 were excluded as they did not meet the inclusion criteria, or because there were no available data on clinically N0 patients, the data were secondary, or because the authors were contacted but were unable to provide the data requested (authors of the studies were contacted where required for information about individual patient data to ensure a subgroup meta-analysis could be performed for specific tumour histology of squamous cell carcinoma). From the articles included in the systematic review, it was determined that nine studies fully satisfied the inclusion criteria.