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Cancer of external auditory canal and middle ear | causes, diagnosis, treatment

Synonym: Malignant, Squamous cell carcinoma of middle ear and external auditory canal.
Causes:
Incidence: Rare, more in males.
cancer-middle-ear-eac

Symptoms:

  1. Discharge: blood stained, foul smelling, profuse.
  2. Deafness: increased conductive deafness >> Sensory-neural hearing loss (SNHL) later.
  3. Deep seated pain.
  4. Tinnitus increase.
  5. Vertigo.
  6. Facial paralysis due to erosion.

Signs:

  1. Granulation & polypi friable, bleeds on touch.
  2. Manifestation of spread
  • Skin ulceration, Temporo-mandibular joint and parotid affection.
  • Enlarged hard fixed parotid or upper deep cervical lymph nodes(UDCLN).
  • Last 4 cranial nerves palsies due to:
- Involvement in jugular foramen.
- Involvement in parapharyngeal space by metastasis to retropharyngeal LN.

Investigations:

  1. X ray: bone erosion.
  2. C.T enhancing soft tissue mass with bone destruction.
  3. Biopsy.
  4. Audiogram.
  5. Metastatic work up.

Treatment:

A- Surgical resection + post operative radiotherapy + RND.
B- Palliative radiotherapy.
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Dr.Tamer Mobarak

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