(See also Overview of Head and Neck Tumors Overview of Head and Neck Tumors Head and neck cancer develops in almost 65,000 people in the United States each year. Excluding skin and thyroid cancers, > 90% of head and neck cancers are squamous cell (epidermoid) carcinomas... read more .)
Malignant otic tumors
Basal cell and squamous cell carcinomas may arise in the ear canal. Persistent inflammation caused by chronic otitis media Otitis Media (Chronic Suppurative) Chronic suppurative otitis media is a persistent, chronically draining (> 6 weeks), suppurative perforation of the tympanic membrane. Symptoms include painless otorrhea with conductive hearing... read more may predispose to the development of squamous cell carcinoma. Extensive resection is indicated, followed by radiation therapy. En bloc resection of the ear canal with sparing of the facial nerve is done when lesions are limited to the canal and have not invaded the middle ear. Deeper invasion requires a more significant temporal bone resection. These resections are typically done by surgeons specializing in neurotology or skull base surgery.
Rarely, squamous cell carcinoma originates in the middle ear. The persistent otorrhea Otorrhea Ear discharge (otorrhea) is drainage exiting the ear. It may be serous, serosanguineous, or purulent. Associated symptoms may include ear pain, fever, pruritus, vertigo, tinnitus, and hearing... read more of chronic otitis media may be a predisposing factor. Resection of the temporal bone and postoperative radiation therapy are necessary.
Nonchromaffin paragangliomas (chemodectomas) arise in the temporal bone from glomus bodies in the jugular bulb (glomus jugulare tumors) or the medial wall of the middle ear (glomus tympanicum tumors). They appear as a pulsatile red mass in the middle ear. The first symptom often is tinnitus Tinnitus Tinnitus is a noise in the ears. It is experienced by 10 to 15% of the population. Subjective tinnitus is perception of sound in the absence of an acoustic stimulus and is heard only by the... read more that is synchronous with the pulse. Hearing loss develops, followed by vertigo Dizziness and Vertigo Dizziness is an imprecise term patients often use to describe various related sensations, including Faintness (a feeling of impending syncope) Light-headedness Feeling of imbalance or unsteadiness... read more . Cranial nerve palsies of the 9th, 10th, or 11th nerve may accompany glomus jugulare tumors that extend through the jugular foramen. Excision is the treatment of choice, and radiation is used for nonsurgical candidates.
Benign otic tumors
Sebaceous cysts, osteomas, and keloids may arise in and occlude the ear canal, causing retention of cerumen and conductive hearing loss. Excision is the treatment of choice for all benign otic tumors.
Ceruminous adenomas occur in the outer third of the ear canal. These tumors appear benign histologically and do not metastasize regionally or distantly but they are locally invasive and potentially destructive and should be excised widely.