Abstract
Conclusion: Early-stage detection of temporal bone carcinoma improves the survival rate. When detected at an advanced stage, predicted prognosis is poor even with a combination of surgery, radiotherapy and chemotherapy. Objectives: We evaluated treatment strategies and survival rates in cases of carcinomas of the external and middle ear. Method: Retrospective review of patients treated at Ehime University Hospital during the 32 years from 1977 to 2008. Subjects were 41 patients, consisting of 21 men and 20 women with a mean age of 63.2 years. Modified Pittsburgh staging system: stage I in 11 cases (27%), stage II in 4 (10%), stage III in 6 (15%) and stage IV in 20 (49%). Histopathology: squamous cell carcinoma (SCC) in 35 cases, adenoid cystic carcinoma (ACC) in 3, and adenocarcinoma (AC) in 3. Thirty-eight patients were treated by surgery. Radiation was added postoperatively in 23 patients. Three patients were treated by chemoradiotherapy. Results: The survival rate of carcinomas detected at an advanced stage was poor with a disease-specific 5-year survival rate of 100% in early-stage disease (stage I and II) versus 20.8% in stage III and 27.5% in stage IV disease, irrespective of histopathology of the tumor.
Highlights
Primary carcinoma of the external and middle ear is a rare disease entity which affects 0.8 - 6 per million of population per year [1]
Complete surgical resection with a clear margin is a generally accepted therapeutic modality, but this is often difficult as temporal bone carcinomas are often found in the advanced stage
25 of 41 patients had a history of chronic otitis media or recurrent external otitis, suggesting that continuous external or middle ear inflammation might be a predisposing factor to temporal bone carcinoma
Summary
Primary carcinoma of the external and middle ear is a rare disease entity which affects 0.8 - 6 per million of population per year [1]. It occurs most frequently in people aged 50 - 70 years, with equal gender distribution [2]. Complete surgical resection with a clear margin is a generally accepted therapeutic modality, but this is often difficult as temporal bone carcinomas are often found in the advanced stage. No universal consensus on optimal treatment of temporal bone carcinoma has yet to be established. We reviewed 41 patients with primary temporal bone carcinomas treated in our hospital over the past 32 years. The aim of this paper was to evaluate treatment strategies and survival rates of our patients, in relation to tumor stage
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