Skull Base 2008; 18(3): 167-172
DOI: 10.1055/s-2007-994290
ORIGINAL ARTICLE

© Thieme Medical Publishers

Squamous Cell Carcinoma of the External Auditory Canal

David Lobo1 , José L. Llorente1 , Carlos Suárez1
  • 1Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
Further Information

Publication History

Publication Date:
28 November 2007 (online)

ABSTRACT

Objectives: This study aims to analyze the treatments, prognostic variables, and outcomes of patients with squamous cell carcinomas (SCC) of the external auditory canal (EAC) and middle ear treated in our department over a 15-year period. Design: A retrospective analysis of 19 patients treated in our department between 1990 and 2006. The patients were staged according to the Pittsburgh classification. Patients were treated with either a lateral (LTBR) or an extended temporal bone resection (total or subtotal). Parotidectomy was performed in patients with suspected clinical or radiological invasion and postoperative radiotherapy was the adjuvant treatment in most patients in advanced stages. Results: The overall 5-year survival was 37%. There were no patients in stage I. The survival rates were 100%, 25%, and 16% for stages II, III, and IV, respectively. Facial nerve paralysis (p = 0.007) and lymph node involvement (p = 0.006) were associated with decreased survival rates. Conclusion: SCC of the temporal bone are rare but have a poor prognosis. Lymph node involvement and facial nerve palsy are associated with a poorer outcome. These tumors must initially be treated radically, for which an early diagnosis is important.

REFERENCES

  • 1 Barrs D M. Temporal bone carcinoma.  Otolaryngol Clin North Am. 2001;  34 1197-1218
  • 2 Manolidis S, Pappas D, Von Doersten P. Temporal bone and lateral skull base malignancy: experience and results with 81 patients.  Am J Otol. 1998;  19(suppl) S1-S15
  • 3 Isipradit P, Wadwongtham W, Aeumjaturapat S, Aramwatanapong P. Carcinoma of the external auditory canal.  J Med Assoc Thai. 2005;  88 114-117
  • 4 Kuhel W I, Hume C R, Selesnick S H. Cancer of the external auditory canal and temporal bone.  Otolaryngol Clin North Am. 1996;  29 827-852
  • 5 Devaney K O, Boschman C R, Willard S C, Ferlito A, Rinaldo A. Tumours of the external ear and temporal bone.  Lancet Oncol. 2005;  6 411-420
  • 6 Lim L H, Goh Y H, Chan Y M et al.. Malignancy of the temporal bone and external auditory canal.  Otolaryngol Head Neck Surg. 2000;  122 882-886
  • 7 Testa J RG, Fukuda Y, Kowalski L P. Prognostic factors in carcinoma of the external auditory canal.  Arch Otolaryngol Head Neck Surg. 1997;  123 720-724
  • 8 Lewis J S. Temporal bone resection: review of 100 cases.  Arch Otolaryngol. 1975;  101 23-25
  • 9 Moffat D A, Wagstaff S A, Hardy D G. The outcome of radical surgery and postoperative radiotherapy for squamous carcinoma of the temporal bone.  Laryngoscope. 2005;  115 341-347
  • 10 Yin M, Ishikawa K, Honda K et al.. Analysis of 95 cases of squamous cell carcinoma of the external and middle ear.  Auris Nasus Larynx. 2006;  33 251-257
  • 11 Yoon M, Chogule P, Dufresne R, Wanebo H. Localized carcinoma of the external ear is an unrecognized aggressive disease with a high propensity for local regional recurrence.  Am J Surg. 1992;  164 574-577
  • 12 Sasaki C T. Distant metastasis from ear and temporal bone cancer.  ORL J Otorhinolaryngol Relat Spec. 2001;  63 250-251
  • 13 Shih L, Crabtree J A. Carcinoma of the external auditory canal: an update.  Laryngoscope. 1990;  100 1215-1218
  • 14 Baldo Sierra C, Suarez Nieto C, Llorente Pendas J L, Bernardo Corte M J. Primary tumors of the external auditory canal [in Spanish].  Acta Otorrinolaringol Esp. 1992;  43 439-442
  • 15 Arriaga M, Cartin H, Hirsch B E, Takahashi H, Kammerer D B. Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and CT findings.  Ann Otol Rhinol Laryngol. 1990;  99 714-721
  • 16 Medina J E, Park A O, Neely J G, Hill Britton B. Lateral temporal bone resections.  Am J Surg. 1990;  160 427-433
  • 17 Rodríguez Paramás A, Gil Carrasco R, Arenas Britez O, Yurrita Scola B. Malignant tumours of the external auditory canal and of the middle ear [in Spanish].  Acta Otorrinolaringol Esp. 2004;  55 470-474
  • 18 Choi J Y, Choi E C, Lee H K, Yoo J B, Kim S G, Lee W S. Mode of parotid involvement in external auditory canal carcinoma.  J Laryngol Otol. 2003;  117 951-954
  • 19 Hashi N, Shirato H, Omatsu T. The role of radiotherapy in treating squamous cell carcinoma of the external auditory canal, especially in the early stages of disease.  Radiother Oncol. 2000;  56 221-225
  • 20 Knegt P P, Ah-See K W, Meeuwis C A, van der Velden L A, Kerrebijn J D, De Boer M F. Squamous carcinoma of the external auditory canal: a different approach.  Clin Otolaryngol Allied Sci. 2002;  27 183-187
  • 21 Hirsch B E. Staging system revision.  Arch Otolaryngol Head Neck Surg. 2002;  128 93-94

José L LlorenteM.D. Ph.D. 

C/J.M. Caso 14

33006 Oviedo, Asturias, Spain

Email: llorentependas@telefonica.net