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EAR CANCER or TUMOR OF EAR created by KIRAN K. KARETHA

Detailed presentation on ear cancer covering its types, causes, symptoms, staging, diagnostic methods, and management including surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.

Health & Medicine◦
Related topics:
Diagnostic Evaluation• Radiation Therapy•
Classified as Microsoft EAR CANCER • PRESENTED BY: • MS. KIRAN K. KARETHA • M.SC (N), MSN (CCN)
Classified as Microsoft INTRODUCTION • Ear cancer accounts for less than 0.2% of all head and neck cancers. • It most commonly affects older adults, although it can occur at any age. • Because its symptoms resemble those of chronic ear infections, diagnosis is often delayed. • Early diagnosis greatly improves treatment success and survival
Classified as Microsoft DEFINITION •Ear cancer is a rare malignant tumor that develops in any part of the ear, including the outer ear (pinna), external auditory canal, middle ear, inner ear, or temporal bone.
Classified as Microsoft TYPES •1. External Ear (Pinna) Cancer •Most common site of ear cancer. •Usually arises from skin exposed to sunlight. •Common histological types: • Squamous cell carcinoma (most common) • Basal cell carcinoma • Melanoma
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Classified as Microsoft CONTI.. •2. External Auditory Canal (Ear Canal) Cancer •Rare but locally aggressive. •Usually squamous cell carcinoma. •May invade: • Temporal bone • Parotid gland • Facial nerve • Skull base
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Classified as Microsoft CONTI.. •3. Middle Ear Cancer •Very rare. •Usually associated with chronic ear infections. •Histological types include: •Squamous cell carcinoma •Adenocarcinoma
Classified as Microsoft CONTI.. •4. Inner Ear Cancer •Extremely rare. •Usually results from spread of nearby cancers rather than a primary tumor.
Classified as Microsoft CAUSES AND RF • The exact cause is unknown, but contributing factors include: • DNA damage from ultraviolet radiation • Chronic inflammation • Recurrent ear infections • Genetic mutations • Exposure to carcinogens • Previous radiation therapy • HPV infection (in selected cases)
Classified as Microsoft CLINICAL MANIFESTATION • Early Symptoms • Persistent ear pain (otalgia) • Ear discharge (often blood-stained) • Hearing loss • Ear fullness • Persistent itching • Non-healing ulcer on the pinna • Visible ear mass
Classified as Microsoft CONTI.. • Advanced Symptoms • Facial nerve weakness or paralysis • Severe headache • Vertigo • Tinnitus • Swelling around the ear • Difficulty opening the mouth (if locally advanced) • Skull base involvement causing cranial nerve deficits
Classified as Microsoft STAGES •Stage I (Early Localized Disease) •Tumor is confined to the external ear or external auditory canal. •No invasion of the bone or surrounding soft tissues. •No regional lymph node involvement. •No distant metastasis.
Classified as Microsoft CONTI.. •Stage II (Localized Advanced Disease) •Tumor has grown larger and extends into the cartilage, soft tissues, or limited temporal bone. •May partially involve the ear canal. •No regional lymph node involvement. •No distant metastasis.
Classified as Microsoft CONTI.. •Stage III (Locally Advanced Disease) •Tumor invades nearby structures •May spread to regional lymph nodes. •No distant metastasis.
Classified as Microsoft CONTI.. •Stage IV (Advanced Ear Cancer) •Stage IV is the most advanced stage of ear cancer and is divided into three substages: •Stage IVA: Tumor invades nearby structures such as the inner ear, facial nerve, temporomandibular joint (TMJ), or deep soft tissues. Regional lymph nodes may be involved.
Classified as Microsoft CONTI.. •Stage IVB: Tumor extends to the skull base, dura (brain covering), major blood vessels, or multiple cranial nerves. It is often difficult to remove completely by surgery. •Stage IVC: Cancer has spread (metastasized) to distant organs such as the lungs, liver, bones, or brain.
Classified as Microsoft DIAGNOSTIC EVALUATION • History and Physical Examination • Assess symptoms and examine the ear and neck. • Otoscopy • Visualizes the ear canal and detects any mass, ulcer, or bleeding. • Biopsy (Gold Standard) • Confirms the diagnosis
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Classified as Microsoft CONTI.. • CT Scan • Detects bone involvement and the extent of the tumor. • MRI • Evaluates soft tissue spread and involvement of nearby structures. • PET-CT Scan • Detects lymph node involvement and distant metastasis. • Audiometry • Assesses hearing loss.
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Classified as Microsoft MANAGEMENT • Surgical Management Surgery is the primary treatment for most ear cancers. The type of surgery depends on the size, location, and stage of the tumor. • 1. Wide Local Excision • Performed for small cancers of the outer ear (pinna). • The tumor is removed along with a margin of healthy tissue to reduce the risk of recurrence. • Reconstruction of the ear may be required if a large area is removed.
Classified as Microsoft CONTI.. •2. Mohs Micrographic Surgery •Used mainly for early-stage skin cancers of the outer ear. •The tumor is removed layer by layer, and each layer is examined under a microscope until no cancer cells remain. •Preserves as much healthy tissue as possible and has a high cure rate.
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Classified as Microsoft CONTI.. •3. Lateral Temporal Bone Resection (LTBR) •Commonly performed for early cancers of the external auditory canal. •Removes: External auditory canal, Eardrum (tympanic membrane), Part of the temporal bone •Hearing in the affected ear is usually lost after surgery.
Classified as Microsoft CONTI.. •4. Subtotal Temporal Bone Resection (STBR) •Performed for more advanced tumors involving the middle ear or deeper temporal bone. •Removes a larger portion of the temporal bone and nearby affected tissues. •May affect hearing and facial nerve function.
Classified as Microsoft CONTI.. • 5. Total Temporal Bone Resection (TTBR) • Used for extensive or advanced ear cancers. • Removes most or all of the temporal bone and may include nearby structures if involved. • May require removal of the facial nerve if it is invaded by the tumor. • Often followed by reconstructive surgery and radiotherapy.
Classified as Microsoft CONTI.. • 6. Parotidectomy • Removal of the parotid gland when the cancer has spread to or is close to the gland. • May be: • Superficial parotidectomy: Removes the superficial lobe. • Total parotidectomy: Removes the entire gland.
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Classified as Microsoft CONTI.. •2. Radiation Therapy •Indications •Postoperative treatment for high-risk disease •Positive surgical margins •Unresectable tumors •Palliative treatment
Classified as Microsoft CONTI.. • 3. Chemotherapy • Usually combined with radiation in advanced disease. • Common drugs: • Cisplatin • Carboplatin • 5-Fluorouracil • Paclitaxel
Classified as Microsoft CONTI.. •4. Targeted Therapy •Used for selected advanced tumors. •Examples: •Cetuximab
Classified as Microsoft CONTI.. •5. Immunotherapy •For recurrent or metastatic disease. •Examples: •Pembrolizumab •Nivolumab
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