Friday , October 23 2020

Cancer of the Ear

By Dr. James M. Davenport, F-AAA, CCC-A –
Cancer of the EarCancers of the ear are uncommon and most develop in the skin of the outer ear, otherwise known as the pinna. Cancers can also develop inside the ear, however, these cancers are very rare. Most ear cancers are known as squamous cell carcinoma. Also basal cell carcinoma and malignant melanoma are mainly cancers which can also arise in the ear.
Cancer of the ear is a type of head and neck cancer- a cancer of the epithelium cells that make up tissues within the head and neck. Patients with ear cancer often experience pain associated with cancer growth within the ear, and may also develop difficulties with balance if the cancer growth interferes with structures within the ear canal.
Cancer of the External Ear
Cancer of the external ear usually shows as a slowly progressing ulcer or as a persistent area of crusting. Usually, these ulcers or crusting appear on the upper edge of the outer part of the ear. These ulcers or areas of crusting can be present for months and or many years. Sometimes a swelling or lump in the neck may also be detected.
What Causes External Ear Cancer and Can It Spread?
The number one cause of these cancers is prolonged exposure to the sun. There is an increased risk of cancer of the skin of the external ear for people who have experienced long periods of exposure to the sun in their daily life, especially pale skinned individuals. If the cancer were to spread, it would most likely spread to the nearby lymph glands in the neck
How is This Treated?
If the cancer is confined to the outer edge of the ear, typically this is treated by surgery. Typically the surgeon will make a wedge-type incision and then sutured or stitched for a good cosmetic result. Many of these small cancers of the outer ear can be treated this way, with no further treatment necessary except for regular follow-up visits for monitoring. On some occasions, the whole external ear will have to be removed, known as a total pinnectomy.
Following a total pinnectomy, reconstructive surgery or prosthesis (artificial replacement) is completed in order to reconfigure the external ear. Sometimes, if the lymph nodes in the neck are involved, an operation will be required to remove the lymph glands on one or both sides of the neck, known as a neck dissection.
Cancer of the Ear Canal
These cancers are rare, but when they do occur, they are most likely to be a squamous cell carcinoma. Cancers of the glands of the ear can occur, however, these are also extremely rare. Cancer of the glands of the ear is likely to be of a type known as adenoid cystic carcinoma. These types of cancers can be found in the outer portion of the ear canal or in the deeper portion of the ear canal.
What are the Symptoms?

  • Discharge from the ear canal, often tinged with blood
  • Hearing loss
  • Earache
  • Sometimes facial paralysis on the side of the affected ear

The cause of these cancers are unknown, however, it would appear to be more common in older individuals who have a long history of outer ear infection called ‘otitis externa’.
Can It Spread?
Yes, this type of cancer can spread into portions of the middle ear. Also, it is possible for the cancer to spread into the parotid gland (salivary gland located beneath the ear and around the angle of the jaw), or backwards into the middle ear. It can also spread to the lymph nodes, which are located in front of and behind the ear as well as the neck, although this is rare in most cases.
How is It Treated?
These types of cancers can be treated surgically. Often, the surgical procedure would consist of using a combination of a common middle ear surgery known as a mastiodectomy, along with removal of the parotid gland. Sometimes removal of the tempero-madibular joint (jaw joint) is a possibility, but is almost never done and would be followed with a neck dissection. Some patients have radiotherapy as the first treatment for cancer of the ear, however, radiotherapy is usually given post operatively destroying any small areas of cancer cells which cannot be removed surgically.
Cancer of the Middle Ear
This type of cancer is mainly known as squamous cell carcinoma; however is very rarely encountered.
What are the Symptoms?

  • Long-term discharging ear
  • Hearing loss
  • More recent blood-stained discharge
  • Sometimes facial paralysis

Can It Spread?
It commonly spreads to the surrounding close structures such as the bone, and can damage the facial nerve, causing facial paralysis. It can also spread to the lymph nodes. This will be checked by regular examination of the neck and a CT scan.
How is It Treated?
This form of cancer can be identified by a biopsy. CT or MRI scanning will show the extent of the tumor. A team of specialists will explain the best course of action and why. Also discussed will be the alternatives and any possible side effects of any treatment options. Most often it is treated surgically followed by post operative radiotherapy in order to destroy small areas of cancer cells not able to be removed at the time of operation. Your team will talk to you about the effects of the operation, which will include deafness on that side.
Glomus Tumor
Glomus tumors are benign, rarely malignant, tumors of the ear that arise from the outer layers of the blood vessels found in the middle ear.
What are the Symptoms?

  • Usually seen as a polyp in the middle ear
  • Hearing loss
  • Pulsating tinnitus
  • Blood-stained ear discharge
  • Dizziness/Vertigo
  • Facial paralysis
  • Earache

What Caused It?
The cause is not really known. Symptoms are very slow to progress so, in many cases, the patient has not consulted his or her GP until later symptoms, such as an earache or tinnitus. The doctor will notice an obvious middle ear polyp upon examination of the ear or a red or blue-tinged swelling behind the eardrum.
How is It Treated?
The details of the treatment are specific to the place from which the tumor originated, and it depends on how large it has become. More often than not, it can be removed surgically, and depending on the likelihood of nerve damage, radiotherapy can slow the growth and keep the disease in check for many years.
To learn more about cancer of the ear or to schedule an appointment, please call Lake County Hearing & Balance Clinic at (352) 343-4488, or visit us online at www.lakecountyhearingclinic.com

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