This document discusses tumors of the ear, including benign and malignant tumors of the auricle, external auditory canal, and middle ear. It describes common tumor types such as sebaceous cysts, dermoid cysts, keloids, and various carcinomas. Diagnostic procedures include imaging, biopsy, and treatment involves surgical excision, radiation, or chemotherapy. Nursing care focuses on supporting the patient, educating them about their condition and treatment, and preventing infection.

1. Tumors of ears
Prepared By
Bidya Thapa
Roll No:- 09
BNS 3rd year

2. Tumors of the ear
 A tumor, also known as a neoplasm, is an abnormal
mass of tissue which may be solid or fluid filled.
Simply, a tumors is a kind of lump or swelling. (A
mass usually refers to a lump which is at least 20mm
in diameter at its widest point, while a nodules less
than 20 mm at widest point). A tumor does not
means cancer.

3.  Tumors can be benign (not cancerous), premalignant
(pre-cancerous), or malignant (cancerous). There are
different types of tumors and variety of names for
them-their names usually reflect their shape and the
kind of tissue they appear in.

4. Tumors of Auricle

5. Benign tumors
1. Preauriclar sinus or cyst
 This results from faulty union of hillocks of the first
and second branchial arches during the development
of pinna. Patient usually presents with cyst which is
infected.
2.Sebaceous cyst
 Common site is postauricular sulcus or below and
behind the ear lobe. Treatment is total surgical
excision.
3.Dermoid cyst
 Usually presents as round mass over the upper part
of mastoid behind the pinna.

6. 4.Keloid
 It often follows trauma such as piercing the ear
lobule for ornaments or a surgical incision. Keloid
presents as a pendunculated tumor.
5.Haemangioma
 They are congenital tumors often seen in childhood.
6.Papilloma
 It may present as a tufted growth or flat grey plaque
and is rough to feel. It is viral in origin.

7. 7.Cutaneous horn
 It is a form of papilloma with heaping up of keratin
and presents as horn-shaped tumor.
8.Keratocanthoma
 It is a benign tumor clinically resembling a malignant
one. Initially , it grows rapidly but slowly regresses
leaving a scar.
9Neurofibroma
 It presents as a non tender, firm swelling.

8. Malignant tumor
1.Squamous cell carcinoma
It may presents as a painless nodules or an
ulcer with raised everted edges and indurated
base.
Metastases to regional lymph node occurs
very late. Disease is more common in males in
their fifties who had prolonged exposure to
direct sunlight.

9. 2.Basal Cell carcinoma
 The common sites are the helix and the tragus. It
presents as a nodule with central crust, removal of
which results in bleeding. Lesion often extends
circumferentially into the skin but may penetrate the
deeper, involving cartilage or bone.
3.Melanoma
 It may occur anywhere over the auricle . it is more
common in men of light complexion who are
exposed to sun. metastases are seen in 16-50% of
the cases.

10. Keloid

11. Papiloma

12. Cutaneous horn

13. Tumor of external Auditory Canal

14. Benign tumors
1.Osteoma
• It arises from cancellous bone and presents as a
single, smooth, bony, hard pedunculated tumour .
often arising from the posterior wall of the osseous
meatus near its outer end.
2.Exostoses
• They are multiple and bilateral, often presenting as
smooth, sessible, bony swellings in the deeper part
of the meatus near the tympanic membrane.

15. 3.Ceruminoma
• It is tumour of modified sweat glands which secrets
cerumen. It presents as a smooth, firm skin-covered
polypoid swelling in the outer part of the meatus,
generally attached to the posterior or inferior wall.
4.Sebaceous Adenoma
• It arises from sebaceous glands of meatus and
presents as a smooth, skin covered swelling in the
outer meatus.
5Papilloma

17. Tumor of Middle ear

18. Benign tumors
1. Cholesteatoma : these are tumors of the middle ear
which are usually benign and the most common of
all middle ear tumors. cholesteatoma arises from a
perforation of the tympanic membrane within the
growth of skin into the middle ear. They also appear
congenitally from an epidermoid formation.

19. 2.Glomus tumors : it is the most common benign
neoplasm of middle ear. They arises from glomus
bodies . glomus bodies are tiny, normal structures in
the middle ear which serve as baro receptors. The
tumor consists of paraganglionic cells derived from
neural crest. For purposes of diagnosis and treatment,
two types are differentiated:
• Glomus jugulare: they arise from the dome of
jugular bulb, invade the hypotympanum and jugular
foramen, causing neurological signs of IXth and XIIth
cranial nerve involvement.
• Glomus tympanicum: they arise from the
promontory of the middle ear and cause aural
symptoms, some times with facial paralysis.

20. Malignant tumor
Squamous cell carcinoma is the commonest malignant
tumor of the middle ear which is characterized by
earache, blood stained otorrhea and rapidly
progressive hearing loss. Later on intense pain, facial
nerve paralysis and vertigo accurs.

21. Acoustic neuroma
Acoustic neuroma is also known as vestibular
schwannoma, neurilemmoma or eight nerve tumor.
The tumor almost always arises from the schwann cells
of the vestibular , but rarely from the cochlear division
of VIIIth nerve within the internal auditory canal . As it
expands , it causes widening and erosion of the canal
and then appears in cerebellopontine angle. Here, it
may grow anterosuperiorly to involve Vth nerve of
inferiorly to involve the IXth , Xth and XITh cranial
nerves.

22. Diagnostic procedure
• History of growth (slow growing or fast growing)
• Plain radiography of temporal bone and CT scan to
see bony erosion and spread of tumor.
• Biopsy of the mass to detect the types cell
involvement and find out either malignant or benign.

23. Treatment
• Aural irrigation is done to keep the canal free
of collected debris as often as necessary.
• Surgical excision of tumor.
• Radiation therapy.
• Chemotherapy

24. Nursing Management
• Reassure the patient giving psychological support to
control anxiety.
• Teach the patient and family members about
disease condition and treatment process.
• Prepare the patient for surgery if needed.
• Educate the patient about side effect of radiation
and chemotherapy.
• Ensure soft and nutritious diet.
• Encourage to maintain healthy surrounding
environment to prevent infection because patient
more prone to infection after following radiation or
chemotherapy.

25. References
• Sharma M, Paudel K, Gautam R.Comprehensive
Text book of Medical Surgical Nursing.3rd ed.
Ghattekulo: Samiksha publication; 2020.
• Mandal GN. Textbook of medical surgical
nursing(adult nursing).7th ed. kathmandu : Safal
publication;2077.
• Dhingra PL, Dhingra S. Disease of ear nose and
throat and head and neck surgery. Seventh
edition :Elsevier relx india pvt. Ltd;2019