Treatment of Carcinoma of the Middle Ear

Abstract

31 patients with carcinoma of the middle ear were observed over a period of 15 years. Polytomography was used to determine the local extent of the disease. Of 22 patients given radical therapy, 15 were treated by mastoidectomy followed by radiation therapy. The 5-year survival rate was 40%, which is in agreement with the findings of several other authors. Patients treated by irradiation alone had a poor survival rate.

Results in treatment of carcinoma of the external auditory canal and middle ear

“…When exceeding a radiation dose of 10 Gy, weekly complications like osteoradionecrosis and mastoiditis are reported to occur.1', 17 We recommend not exceeding 10 Gy per week, as we did not see any complications to radiotherapy.…”

Verrucous Carcinoma of the Temporal Bone

“…It is important in providing palliation of pain, discharge or bleeding in unresectable lesions. 21 Radiotherapy has been used in combination with surgery in four of the nine reported cases of verrucous carcinoma of the temporal bone (including the present case). Chemotherapy was used alongside radiotherapy in two of these cases, ' ' * I 3 and by itself following surgery in another separate case.I3 All these patients had surgically unresectable disease.…”

Verrucous Carcinoma of the Temporal Bone: A Wolf Clothed in Wool

“…Two patients had other cranial nerve deficits at their initial assessment. 7,10 The array of symptoms and signs largely matches those exhibited by all types of cancer of the middle ear, 4,6 the predominant type being conventional, nonverrucous squamous cell carcinoma.…”

“…However, with stereotypical multiple failed attempts at definitive histological diagnosis of the main tumor, the most likely diagnosis was a conventional squamous cell carcinoma. 3,5,6 Furthermore, nodal sampling may be nonrepresentative. A more central question was the choice of surgery as the primary treatment.…”

“…However, it has not been advantageous for survival. 6 In advanced cases, radiotherapy should be considered as an alternative to surgery based on the patient's likely longevity with either option, general health, and opinion of ''acceptable morbidity.'' 20…”