Ear consists of 3 parts – external (auricle and external auditory canal), middle and internal. All ear tumors can be divided into three groups: benign, locally destructive and malignant. The disease affects both men and women equally, and is more often diagnosed after the age of 40. Ear neoplasms most frequent localization is auricle (80% of cases), in 15% external auditory canal is affected, and only 5% of patients are diagnosed with cancer of middle ear.
As a rule, ear malignant tumor is formed against the background of certain pre-existing ear disease, for example, otitis externa or otitis media, or permanent ear traumatization. As the tumor progresses, it can grow into nearby anatomical structures and cause certain complications: neoplasm can reach inner ear structures, sprouting into temporal bone, affect cranial nerves and brain membranes with their carcinomatosis development. Later such formation can grow into internal carotid artery, provoking massive and fatal bleeding into cranial cavity. At stage 3 and 4, tumor metastasizes to regional lymph nodes. Metastases to distant organs are not typical for ear cancer.
Accordingly, ear malignant lesions are serious diseases with serious prognosis, and the earlier they are detected and specific treatment is carried out, the better prognosis. If you suspect a certain ear problem or you have already been diagnosed with outer or middle ear tumor – do not waste precious time, consult a professional oncologist and otolaryngologist. Such specialists work in Oncology Department Maimonides Multidisciplinary Medical Center. Our clinic works on the model of one of the best Israeli oncology centers and in close cooperation with it. Each clinical case is monitored not only by the attending oncologist, but also by the head of the department – Dr. Stefanska Irina and responsible oncologist directly from Israel. Thus, in Ukrainian conditions, every patient can get access to the best medicine of Israeli model.
Maimonides Medical Center also works under the patronage of charitable foundation of “Keren Or for our Child” the Charitable Foundation, so all our patients have the opportunity to receive financial assistance for expensive treatment of malignant tumors.
Ear cancer is a serious disease, but it is completely curable with timely diagnosis and modern comprehensive treatment approach. In our department, patient is assisted not only by oncologists, but also by the rest of necessary narrow specialists – ENT doctors, surgeons, neurosurgeons, plastic surgeons, psychologists, radiation therapists, chemotherapists, rehabilitators, etc. In their practice all specialists are guided by modern evidence-based clinical recommendations and world treatment protocols, so patient can not worry about selected comprehensive treatment adequacy.
At the same time, selection process of examination plan and treatment regimen takes place purely on an individual basis . Specialists take into account everything down to the smallest details – age, patient’s gender, main oncological diagnosis, tumor size and localization, its spread to neighboring tissues, disease stage, patient’s general condition, concomitant severe pathologies presence, patient’s wishes regarding treatment program. This patient-oriented approach allows to get the best treatment results and a good long-term prognosis.
Maimonides Medical Center employs only highly qualified specialists who have repeatedly completed internships at the best world’s oncology centers (USA, Germany, Israel). All of them have an excellent command of modern diagnostic methods, are able to interpret obtained results without error, masterfully use the most modern operative techniques, and have communication skills with oncology patients.
If a certain narrow specialist or rare medical and diagnostic equipment is not available, patient is referred to subsidiary institutions of Maimonides Medical Center or our Israeli partner clinics, where he is guaranteed to receive the full range of necessary medical services, where he is guaranteed to receive the full range of necessary medical services.
Ear cancer causes and symptoms
The direct cause of ear cancer is a mutation in a certain cell , which leads to its uncontrolled division and growth, as a result, a tumor is formed. Unfortunately, the reasons that trigger this process are still unknown. Although there are factors that significantly increases the risk of cancer ear. They include:
- Border auricle and external auditory canal skin nevi.
- Ear papillomas presence and carriage of human papilloma virus.
- Chronic otitis externa and otitis media.
- Frequent auricles mechanical injuries, burns, frostbite.
- Chronic eczema with external ear skin damage.
- Ear skin psoriatic lesions.
- Systemic lupus erythematosus.
- Heavy heredity for ear tumors.
- Ionizing radiation adverse effects (increased radiation background, head and neck radiation therapy in the past).
- Excessive insolation.
Among the common symptoms of outer ear tumor are knot formation, auricle or inside auditory canal ulcers or granulations, itching, ear burning, pain, extraneous noises presence, one side hearing impairment. Purulent, bloody or purulent dischargefrom the ear may appear. In future, symptoms of facial nerve damage may appear – facial muscle paresis. In case of regional lymph nodes metastases spread, they increase in size and become available for palpation.
For a long time, middle ear tumor is disguised as chronic otitis media. Purulent or bloody discharge may appear from the ear, hearing gradually decreases on the affected side. As the tumor grows, ear pain and headache begin, and regular dizziness appears. Further, the symptoms depend on tumor growth into certain adjacent anatomical structures. When the parotid salivary glands and pharynx are damaged, swallowing is disturbed. When facial or trigeminal nerve is damaged, there are corresponding neurological manifestations. At carotid artery damage, there is intracranial bleeding. When brain meningeal membrane is damaged, there are signs of meningitis.
Ear tumors types
All ear tumors can be divided into outer and inner ear neoplasms. Also for malignant and benign tumors. There are also locally destructive options, when tumor does not have classic malignancy signs. It means that it does not metastasize, but can spread to neighboring tissues, destroying them.
External ear benign neoplasms are quite common tumors. They affect auricle and external auditory canal.
The most common types of external ear benign tumors are:
- Papilloma – can be localized on auricle skin and less often inside ear canal.
- Ceruminoma (athenoma) is a rare benign tumor located in ear canal, growing from sulfur glands. As the tumor grows, it fills the entire auditory canal, spreads to middle ear, and leads to its walls destruction. Therefore, this tumor can also be classified as locally destructive.
- Fibroma is connective tissue benign tumor, located mainly on auricle in pierced places.
- Hemangioma are benign tumors from blood vessels that can be localized in all parts of the ear. When such tumors are injured, serious bleeding can develop.
- Chondroma is cartilaginous tissue benign tumor, it is detected quite rarely, localized in auditory canal and can completely close it.
- Osteoma is benign tumor from bone tissue, localized in auditory canal or in temporal bone mastoid process.
- Osteoblastoclastoma is a rare benign bone tissue tumor. They have the ability for local infiltrative growth and a part of temporal bone destruction.
- Cholesteatoma is a benign tumor of embryonic tissue capable to local destructive growth.
External ear malignant tumors are:
- Basal cell skin cancer of auricle and auditory canal – mainly affects auricle, rarely external auditory canal.
- Squamous cell carcinoma affects all parts of outer ear.
- Melanoma is a malignant tumor from melanocytes pigment cells.
- Sarcoma.
Ear cancer diagnostic methods
The stage of diagnosis is very important in order to get a victory over disease, and even more so an oncological one. Examination should be quick and accurate. At Maimonides Medical Center, all patients can count on efficient and quick diagnostics. Our specialists master modern examination methods and accurately interpret received data. Also modern expert-class diagnostic equipment makes examination process comfortable and safe for patient.
Diagnosis begins with an in-person consultation. During the appointment, specialist will ask patient in detail about the symptoms, collect medical and life anamnesis, determine possible provoking factors, thoroughly examine all organs and systems, and also conduct an ENT examination independently or with the help of an otolaryngologist. Based on received data, specialist will make up further examination plan using modern laboratory and instrumental methods.
An accurate diagnosis is made after conducting the following studies:
- Otoscopy – allows us to examine ear canal and eardrum carefully, it is performing using a special optical device of the otoscope. Otoscopy helps to detect a tumor of ear outer parts and to suspect damage to the middle ear.
- Neoplasm biopsy and histological examination of obtained tissue sample. After biopsy we send all materials for revision to the best world’s pathogistological laboratories (USA, Germany). Thanks to such double molecular checks, we are absolutely sure of diagnosis correctness and selected treatment tactics adequacy.
- Medical imaging techniques – CT, MRI, PET-CT, PET-MRI, bone scintigraphy. These examinations allow us to learn more detailed information about tumor size, localization and its type, distribution, possible metastases to distant organs.
- Also audiometrymay be required in additional cases. This procedure helps determine auditory analyzer condition, diagnose hearing loss even in early stages.
Many innovative and modern diagnostic methods are used in our medical center. Their choice is oncologist prerogative, depending on clinical situation of each patient. All necessary diagnostic procedures can be performed directly in clinic, without leaving Ukraine.
Ear cancer modern treatment
A multidisciplinary group of specialists usually deals with patient’s ear oncological diseases treatment. This group includes:
- surgeons specializing in head and neck diseases treatment (otolaryngologists, maxillofacial and plastic surgery specialists);
- chemotherapy and radiation therapy specialists (oncologists);
- dentists;
- nurses who have undergone special training, as well as physiotherapists and nutritionists, psychologists.
The approach to ear cancer treatment is only complex, that is, several types of treatment schemes are used at the same time, which together give a good effect and a good prognosis. As a rule, this is a combination of surgical interventions, radiation therapy, chemotherapy, some other treatment options, depending on specific clinical situation.
Tumor surgical removal is the main ear cancer treating method. The type and volume of surgical intervention depends on tumor localization and the extent of its spread to neighboring tissues and other structures, including bone tissue.
Surgeon removes malignant neoplasm along with healthy tissue fragment surrounding it. To ensure wound edges cleanliness (malignant cells absence), surgeon removes at least 5 mm of healthy tissue around tumor perimeter. This preventive measure reduces tumor recurrence risk in future.
After tumor radical removal, the next stage of surgical treatment can be reconstructive plastic surgery to eliminate cosmetic defect that has formed, such as auricle absence. Patients are implanted with prostheses made of hypoallergenic materials that completely repeat auricle anatomical shape.
Radiation therapy is a malignant neoplasms treating method based on ionizing radiation application to destroy malignant cells. Radiation therapy is prescribed:
- as the main cancer treatment method;
- after surgery, if the surgeon failed to ensure wound edges cleanliness;
- in combination with chemotherapy (chemo radial therapy).
Postoperative radiation therapy reduces disease recurrence risk.
At initial consultation, a radiation therapy specialist (radiation oncologist) plans a treatment scheme. Planning usually takes a couple of hours, but each subsequent radiation therapy session lasts only a few minutes.
Chemotherapy is antitumor (cytotoxic) drugs application to destroy malignant cells. Chemotherapy alone cannot cure ear cancer. Doctors prescribe it to patients who are contraindicated for other methods treatment or in combination with surgery or radiation. In addition, chemotherapy effectively alleviates disease symptoms.
Patients with auditory canal, middle and inner ear cancer are most often prescribed fluorouracil and cisplatin. All chemotherapy drugs that we prescribe to patients are manufactured only by the most famous pharmaceutical companies in the world. Thanks to this approach, we are absolutely sure of treatment effectiveness and its safety.
Also, all our patients have the opportunity to become participants in clinical trials of experimental treatment methods. For some of them, this is the only chance for recovery, especially for those people for whom all standard treatment methods have proven ineffective.