Latar belakang: Keganasan pada kanalis akustikus eksternus (KAE) merupakan kasus yang jarang terjadi, kurang dari 0,2 % dari seluruh keganasan pada regio kepala dan leher. Secara histologis, karsinoma sel skuamosa merupakan jenis karsinoma terbanyak, terjadi pada 80% kasus. Karsinoma sel skuamosa KAE masih menjadi tantangan bagi praktisi medis dalam mendiagnosis dan menatalaksana. Tujuan: Hingga saat ini, belum ada algoritma yang spesifik dalam menatalaksana kasus ini, sehingga membutuhkan pengetahuan yang mendalam mengenai anatomi dan teknik pembedahan, serta ditunjang dengan adanya tim multidisiplin dalam menangani kasus keganasan KAE. Laporan kasus: Tulisan ini melaporkan 4 kasus pasien karsinoma sel skuamosa KAE yang menjalani bermacam modalitas tatalaksana dengan keluaran yang bervariasi. Metode: Telaah literatur berbasis bukti mengenai tatalaksana karsinoma sel skuamosa KAE melalui database Cochrane dan Pubmed Medline. Berdasarkan kriteria inklusi dan ekslusi didapatkan satu jurnal yang relevan dengan kasus yang dilaporkan. Hasil: Karsinoma sel skuamosa liang telinga terutama ditatalaksana dengan terapi pembedahan. Modalitas tambahan yang dapat diberikan adalah kemoterapi dan radioterapi. Terapi pembedahan seringkali meninggalkan defek yang besar sehingga memerlukan tindakan rekonstruksi. Kesimpulan: Tatalaksana karsinoma sel skuamosa KAE seringkali membutuhkan pendekatan multidisiplin dan kompleks terutama pada kasus stadium lanjut. Angka harapan hidup yang lebih baik akan dicapai dengan mendiagnosis dan menatalaksana kasus ini secara dini. Background: Cancer of the external auditory canal (EAC) is a rare tumor, representing less than 0.2% of all head and neck cancers. Histologically, squamous cell carcinoma comprises more than 80% of cases. Squamous cell carcinoma (SCC) of the EAC is still a therapeutic challenge for medical specialists in its diagnosis and management. Purpose: Up to date, there is no specific treatment guidelines available due to SCC low incidence. The attending physician must have asubstantial knowledge of literatures as well as anatomy and surgical techniques, supported by an appropriate cancer center with adequate multidisciplinary team to offer the best therapy in accordance with the needs of the cancer clinical stages. Cases: This paper reports 4 cases of squamous cell carcinoma of the EAC which underwent various treatment modalities, and yielded also various outcomes. Method: Evidence based literature study about squamous cell carcinoma of EAC was performed through Cochrane and Pubmed Medline database. Based on inclusion and exclusion criteria, one study was found relevant to these cases. Results: The particular choice of SCC management of EAC is surgery, yet SCC of the EAC requires additional modalities such as chemotherapy and radiotherapy. Surgery often leaves a large defect which requires a reconstructive procedure. Conclusion: Cancer of EAC management requires a multidisciplinary approach, especially it is more complex in the advanced stage of SCC. An early stage diagnosis and prompt management will lead to a better survival rate.

Objective: The aim of this study was to acquire supporting data for the rational use of antibiotics in plastic reconstructive surgery in the Ear-Nose-Throat/Head and Neck Surgery Department at Cipto Mangunkusumo Hospital–Faculty of Medicine Indonesia University. Methods: This pilot study, with a negative trial design, included 12 subjects who were randomly divided into two groups: preoperative prophylactic antibiotic-only group and a combination of prophylactic and postoperative antibiotic group (controls). Results: The results showed that only 1 of the 12 subjects (in the prophylactic antibiotic-only group) developed an SSI. None of the controls (combined-use group) had an SSI. The difference between the two groups was not significant. Conclusion: The use of postoperative antibiotic appears not to be necessary in plastic reconstructive surgery patients to prevent SSIs. Further study, however, is required to support the findings of this study.

The number of complications in dangerous Chronic Suppurative Otitis Media (CSOM) remain high, especially in late presentation. Extensive disease with intratemporal and intracranial complications, especially in children, was commonly found in Cipto Mangunkusumo General Hospital (CMGH), a tertiary referral hospital. This was a retrospective study that used secondary data from 2017 to 2019 in CMGH. All paediatric patients with diagnoses of dangerous CSOM and who underwent surgery from January 2017 to June 2019 were included. Clinical and intraoperative findings were described in this study. Twenty paediatric patients underwent surgery in CMGH from 2017 to 2019; of that number, 17 had unilateral dangerous CSOM, and three had bilateral dangerous CSOM. All patients aged 2 to 18 years old underwent canal wall down technique surgery. Profound hearing loss was found in nine ears; severe loss, in four ears; moderately severe loss, in four ears; and moderate loss, in seven ears. The most common intraoperative finding was total ossicular destruction in 17/23 ears. Erosion of sigmoid sinus plate was found in 5/23 ears, with perisinus abscess occurring in one case. Tegmen erosion was found in 4/23 ears. Facial nerve dehiscence was found in seven ears (5 vertical segments, 2 horizontal segments) and two patients had facial nerve paralysis before surgery. Lateral semicircular canal (SCC) fistula was found in 6/23 ears. Late presentation in dangerous CSOM can lead to extensive disease and complication, especially in paediatric patients.

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