Synonym: Malignant, Squamous cell carcinoma of middle ear and external auditory canal.
Causes:
- Chronic Suppurative Otitis Media CSOM.
- Irradiation.
Incidence: Rare, more in males.
Symptoms:
- Discharge: blood stained, foul smelling, profuse.
- Deafness: increased conductive deafness >> Sensory-neural hearing loss (SNHL) later.
- Deep seated pain.
- Tinnitus increase.
- Vertigo.
- Facial paralysis due to erosion.
Signs:
- Granulation & polypi friable, bleeds on touch.
- 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:
- X ray: bone erosion.
- C.T enhancing soft tissue mass with bone destruction.
- Biopsy.
- Audiogram.
- Metastatic work up.
Treatment:
A- Surgical resection + post operative radiotherapy + RND.
B- Palliative radiotherapy.