Speciality
Spotlight

 




 

Otolaryngology


 

    

  




Ear -
Malignancy

     

  • Moody SA, Hirsch BE, Myers EN (Univ of Pittsburgh, Pa)

    Squamous Cell Carcinoma of the External Auditory Canal: An Evaluation of a Staging System 

    Am J Otol 21: 582-588, 2000

            

    Less that 0-2% of squamous cell carcinomas of head and neck are of temporal bone. Staging system for temporal bone carcinoma based on CT scan and clinical information is reported. 

         

    A retrospective of 32 patients treated for primary carcinoma of Ext. Auditory Canal (EAC) over 20 years period. The investigators classified these tumors on preoperative CT findings:-

         

    T1 – Tumors limited to EAC.

        

    T2 – Tumors with limited bone erosion or soft tissue involvement. 

        

    T3 – Tumors eroding the osseous EAC with limited soft tissue involvement. 

        

    T4 – Extensive erosion and soft tissue involvement. 

         

    All patients underwent temporal bone resection with adjunctive procedures as indicated. 

       

    Results- 2 year survival rates – 

        

    100% for T1 stage. 

    80% for T2 stage.

    50% for T3 stage.

    7% for T4 stage.

          

    75% for those with negative margin while 32% for those with positive margins. In T3 patients 75% with postoperative radiotherapy and 0% not receiving radiation. 

          

    The staging system is valid for extent of tumor involvement and for prognosis. In T4 patients prognosis is bad. Facial nerve involvement is a bad prognostic sign.

          
  • Hashi N, Shirato H, Omatsu T, et al (Hokkaido Univ, Sapporo, Japan)

    The Role of Radiotherapy in Treating Squamous Cell Carcinoma of the External Auditory Canal, Especially in Early Stages of Disease

    Radiother Oncol 56: 221-225, 2000

        

    This is a retrospective analysis of 20 patients treated between 1980 to 1988. In 8 patients radiotherapy was used as initial treatment. 

        

    In 12 patients surgery was initial treatment. Follow-up for survival was mean 71 months.

        

    Results: With Kaplan-Meier method, 5 year survival was 59% overall. The shell classification 5-year survival rate for 8 patients with T1 stage was 100% and T2 38%. 

        

    M. M. Paparella believes that the current opinion is that surgery is the primary modality in treatment of carcinoma of the external auditory canal. Radiation should be used when needed. When surgery in early lesion, healing capability is good and avoids osteoradionecrosis of temporal bone often radiotherapy is seen.

         
  • Gloria-Cruz TI, Schachern PA, Paparella MM, et al (Univ of Minnesota, Minneapolis; Ear, Head, and Neck Clinic, Minneapolis) 

    Metastases to Temporal Bones From Primary Nonsystemic Malignant Neoplasms 

    Arch Otolaryngol Head Neck Surg 126: 209-214, 2000

          

    Autopsy records of 864 were retrospectively reviewed of those with primary nondisseminated malignant neoplasms.

          

    Results of 212 patients, 47 had metastasis to the temporal bone. Most often breast cancer was among 20 different primary tumors. Hearing loss was the frequently observed otologic symptoms. Petrous apex was the commonest site of involvement.

         

    Conclusion : Data suggests the metastasis in temporal bone is not uncommon and is often the cause of hearing loss in such patients.

         

    Patients of hearing loss in the patients with history of primary malignant neoplasia elsewhere should be suspected of having metastasis in temporal bone.

         

 



 

Speciality Spotlight

 

    
  

Ear - Malignancy
     

  • Moody SA, Hirsch BE, Myers EN (Univ of Pittsburgh, Pa)
    Squamous Cell Carcinoma of the External Auditory Canal: An Evaluation of a Staging System 
    Am J Otol 21: 582-588, 2000
            
    Less that 0-2% of squamous cell carcinomas of head and neck are of temporal bone. Staging system for temporal bone carcinoma based on CT scan and clinical information is reported. 
         
    A retrospective of 32 patients treated for primary carcinoma of Ext. Auditory Canal (EAC) over 20 years period. The investigators classified these tumors on preoperative CT findings:-
         
    T1 – Tumors limited to EAC.
        
    T2 – Tumors with limited bone erosion or soft tissue involvement. 
        
    T3 – Tumors eroding the osseous EAC with limited soft tissue involvement. 
        
    T4 – Extensive erosion and soft tissue involvement. 
         
    All patients underwent temporal bone resection with adjunctive procedures as indicated. 
       
    Results- 2 year survival rates – 
        
    100% for T1 stage. 
    80% for T2 stage.
    50% for T3 stage.
    7% for T4 stage.
          
    75% for those with negative margin while 32% for those with positive margins. In T3 patients 75% with postoperative radiotherapy and 0% not receiving radiation. 
          
    The staging system is valid for extent of tumor involvement and for prognosis. In T4 patients prognosis is bad. Facial nerve involvement is a bad prognostic sign.
          
  • Hashi N, Shirato H, Omatsu T, et al (Hokkaido Univ, Sapporo, Japan)
    The Role of Radiotherapy in Treating Squamous Cell Carcinoma of the External Auditory Canal, Especially in Early Stages of Disease
    Radiother Oncol 56: 221-225, 2000
        
    This is a retrospective analysis of 20 patients treated between 1980 to 1988. In 8 patients radiotherapy was used as initial treatment. 
        
    In 12 patients surgery was initial treatment. Follow-up for survival was mean 71 months.
        
    Results: With Kaplan-Meier method, 5 year survival was 59% overall. The shell classification 5-year survival rate for 8 patients with T1 stage was 100% and T2 38%. 
        
    M. M. Paparella believes that the current opinion is that surgery is the primary modality in treatment of carcinoma of the external auditory canal. Radiation should be used when needed. When surgery in early lesion, healing capability is good and avoids osteoradionecrosis of temporal bone often radiotherapy is seen.
         
  • Gloria-Cruz TI, Schachern PA, Paparella MM, et al (Univ of Minnesota, Minneapolis; Ear, Head, and Neck Clinic, Minneapolis) 
    Metastases to Temporal Bones From Primary Nonsystemic Malignant Neoplasms 
    Arch Otolaryngol Head Neck Surg 126: 209-214, 2000
          
    Autopsy records of 864 were retrospectively reviewed of those with primary nondisseminated malignant neoplasms.
          
    Results of 212 patients, 47 had metastasis to the temporal bone. Most often breast cancer was among 20 different primary tumors. Hearing loss was the frequently observed otologic symptoms. Petrous apex was the commonest site of involvement.
         
    Conclusion : Data suggests the metastasis in temporal bone is not uncommon and is often the cause of hearing loss in such patients.
         
    Patients of hearing loss in the patients with history of primary malignant neoplasia elsewhere should be suspected of having metastasis in temporal bone.
         

 

 

By |2022-07-20T16:43:16+00:00July 20, 2022|Uncategorized|Comments Off on Ear – Malignancy

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