Early Clinical Presentations in 79 Patients with External Auditory Canal Carcinoma

Abstract

External auditory canal(EAC)carcinoma is a rare disease. Since there are a limited number of studies on the clinical course of EAC carcinoma, the clinical presentations of EAC carcinoma, especially in the early stage of the disease, are yet to be investigated. In this study, we reviewed the clinical records of 79 patients with previously untreated EAC carcinoma and conducted a questionnaire survey to elucidate the clinical features in detail. The median(IQR)age of the 79 patients was 64(51.5-72.5)years, and 42(53.2%)were male. Of the total, 67 patients had squamous cell carcinoma (SCC) , 8 had adenoid cystic carcinoma(ACC) , and 4 had adenocarcinoma. In 5 cases, EAC carcinoma developed after radiotherapy to the head and neck region ; in all 5 cases, the histological subtype of the EAC carcinoma was SCC. The median(IQR)time interval from the onset of symptoms to receiving a definitive diagnosis was 4.0(1.5-11)months : 41.3% of patients received a definitive diagnosis within 3 months, and 57.3% did within 6 months. No correlation was observed between the length of time from the onset of symptoms to receiving a definitive diagnosis and the T-stage of the disease. The definitive diagnosis of EAC carcinoma was made in a clinic in 5.1% of patients, and in the hospital or university hospital in 94.9% of cases. The most common symptoms were otorrhea, otalgia, and bloody otorrhea. According to the questionnaire survey, all 38 patients had a habit of cleaning earwax, and 26(68.4%)patients had been diagnosed earlier in life as having otitis externa. The patient group with ACC showed a longer time from the onset of symptoms to receiving a definitive diagnosis, were younger, complained of otalgia more frequently, and showed a higher risk of EAC stenosis as compared with the patient group with SCC.