Primary cancers of the ear canal are rare; however, when they do occur, basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are the typical culprits. Cancers involving the outer ear (pinna) are more common and arise due to sun exposure (especially common in the desert Southwest). Dermatologists typically manage routine skin cancers of the outer ear; however, large tumors require multi-disciplinary care including a neurotologist.<\/p>\n\n\n\n
BCCs and SCCs arising in the temporal bone (ear canal) occur spontaneously and can spread quickly to adjacent areas like the parotid gland (salivary gland anterior to the ear canal), the neck (inferior to the ear canal), the middle ear (deep\/medial to the ear canal) or the mastoid (posterior to the ear canal). Significant delays in treatment can result in metastases to other locations throughout the body.<\/p>\n\n\n\n
If ear cancer is suspected, a biopsy of the lesion is performed to confirm the diagnosis. Imaging studies such as temporal bone CT scans, PET scans, and\/or MRI scans with internal auditory canal protocol may be ordered to determine the extent of the cancer. Rarely, CT, MRI or catheter-based angiograms are necessary to evaluate blood supply to the tumor as well as integrity of the carotid artery. When possible, a comprehensive audiogram (hearing test) is obtained to document pre-treatment hearing levels.<\/p>\n\n\n\n
Cancers of the ear canal are managed aggressively with temporal bone surgery, radiation therapy and sometimes chemotherapy. A multidisciplinary approach to treatment, including neurotologist, head and neck oncologic surgeon, radiation oncologist, medical oncologist and sometimes neurosurgeon is required. This sort of comprehensive care is rarely available outside of university-based cancer centers.<\/p>\n\n\n\n