Tumors of the ear area are generally rare. Tumors of the ear can be divided into benign or cancerous. The benign tumors can occur from the skin (cysts or ceruminoma) or the lining of the space behind the ear drum (e.g., middle ear adenoma, glomus tumor, facial neuroma or schwannoma among others).
Cancer of the temporal bone and the ear are rare. Usually, these cancers can be caused by cancer of the skin that starts on the outer ear or in the ear canal and invades the bone. These cancers include squamous cell carcinoma of the ear, adenoid cystic carcinoma of the ear, and ceruminomatous adenoid cystic carcinoma, among others. Other cancers of the ear area are caused by invasion from adjacent structures such as the parotid gland (saliva gland that sits in front of the ear canal).
You may reference the Anatomy of the Ear page for better understanding of the anatomy.
Benign tumors of the ear most commonly present by putting pressure against adjacent structures such as the ear drum and can present with hearing loss. In others, the tumor may cause a pulsating sound in the ear that is synchronized with the heartbeat.
The cause of benign tumors is unknown. Some tumors, such as glomus tumors, may occur from genetic abnormalities and can run in families.
Cancers of the ear commonly occur due to irritation to the skin from chronic ear drainage or infections. Another common cause is significant sun exposure to the outer ear.
The diagnosis is made by examination and biopsy of the mass. Almost always imaging studies (such as CT scan (special x-ray) of the temporal bone (ear bone) and/or MRI (special imaging study)) is necessary for diagnosis.
The treatment of benign tumors is its complete removal. If the tumor is small, the surgery can be performed through the ear canal. If the tumor is larger, an incision has to be made from behind the ear to remove some of the bone from behind the ear to allow removal of the full extent of the tumor.
Cancerous tumors of the ear require surgery with or without radiation. The surgery depends on the location of the tumor and the extent of involvement of the bone or the space behind the ear drum.
If the tumor is isolated to the skin of the outer 1/3 of the ear (cartilaginous ear canal), then resection of a section of the ear canal (called a "sleeve resection") can be performed.
If the tumor involves the inner 2/3 of the ear canal (bony ear canal) then a lateral temporal bone resection has to be performed. This involves removing the entire ear canal, ear drum and the first 2 bones behind the ear drum. In addition removal of the parotid gland (saliva gland in front of the ear) and lymph nodes from the neck may be necessary. Sometimes, a portion of the jaw joint may have to be removed as well. Depending on the extent of the tumor, radiation sometimes has to be performed as well. A video of a lateral temporal bone resection can be seen below.
Please note this is a surgical video and may not be suitable for all viewers.
If the tumor involves the space behind the ear drum, then a subtotal temporal bone resection has to be performed (lateral temporal bone resection + removal of the sections of the inner ear). If the inner ear is involved, then more radical surgery has to be performed. Generally, the prognosis is not very good at this stage.
A comprehensive evaluation has to be performed by an experienced team of you and your imaging studies and pathological specimens.
A subspecialist in the field of ear surgery (neurotologist) generally performs this surgery in combination with a head and neck cancer specialist and a reconstructive surgeon as it is a highly technical surgery. Most major medical centers perform very few of these procedures per year.
Due to the sunny nature of Southern California, our team has had extensive experience with cancers of the ear. Our center performs surgery for these types of tumors on a routine basis. The UC Irvine Head and Neck Cancer team includes two neurotologists (Drs. Hamid Djalilian and Harrison Lin), two head and neck cancer specialist (Drs. William Armstrong and Julie Goddard) and a reconstructive surgeon (Dr. Julie Goddard). The team works together with radiation therapists, medical oncologists, pathologists, and radiologists to come up with the best plan for each patient. Each patient is examined and discussed at the weekly tumor conference and a team plan is made. We ensure an individualized plan for every patient and provide the information necessary for the patient to make an informed decision.
To Make an Appointment with our ear specialists, Drs. Djalilian or Lin, Please Call 714-456-7017 or click here to request an appointment via the web.
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