La Tunisie medicale · 2025
External auditory canal carcinomas: What does optimal management require?
СтатьяНазвание и аннотация: Перевод в очереди
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Chahed Houda, Laajilia Rania, Lajhouri Maissa, Dhambri Sawssen, Mediouni Azza, Beltaief Najeh, Kedous Skander
Аннотация
OBJECTIVE: Carcinomas of the external auditory canal (CEAC) are rare with poorly defined treatment guidelines. The aim of this study is to discuss the therapeutic management of patients with CEAC.
METHODS: It was a retrospective study conducted over an 11-year period (2010-2021), including 8 patients with primary CEAC. Cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods and follow- up.
RESULTS: Median age was 58 years with a sex ratio of 0.6. Main symptoms were hearing loss (n=6), otorrhea (n=4), otalgia (n=4), and peripheral facial palsy (n=2). According to the Pittsburgh classification, CEACs were classified as T1N0M0 in 3 cases, T4aN0M0 in 4 cases, and T4bN0M0 in one case. Surgery consisted of a local resection of the tumor in four cases. A lateral temporal bone resection with total ipsilateral parotidectomy and functional neck dissection was performed in three cases with, respectively, a resection of the ipsilateral pinna (2 cases) and of the temporomandibular joint (2 cases). Adjuvant radiotherapy was indicated in 4 cases. Exclusive radiation therapy was indicated in one case. Histopathological examination confirmed 5 cases of squamous cell carcinoma, 2 cases of basal cell carcinoma, and one case of adenoid cystic carcinoma. Surgical margins were negative in 5 cases. Follow-up was favorable without recurrence in six cases. In one case, a progressive disease with patient death was observed.
CONCLUSIONS: Optimal treatment requires early diagnosis and careful imaging assessment of tumor extension to tailor treatment, which often includes surgery and radiotherapy.
METHODS: It was a retrospective study conducted over an 11-year period (2010-2021), including 8 patients with primary CEAC. Cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods and follow- up.
RESULTS: Median age was 58 years with a sex ratio of 0.6. Main symptoms were hearing loss (n=6), otorrhea (n=4), otalgia (n=4), and peripheral facial palsy (n=2). According to the Pittsburgh classification, CEACs were classified as T1N0M0 in 3 cases, T4aN0M0 in 4 cases, and T4bN0M0 in one case. Surgery consisted of a local resection of the tumor in four cases. A lateral temporal bone resection with total ipsilateral parotidectomy and functional neck dissection was performed in three cases with, respectively, a resection of the ipsilateral pinna (2 cases) and of the temporomandibular joint (2 cases). Adjuvant radiotherapy was indicated in 4 cases. Exclusive radiation therapy was indicated in one case. Histopathological examination confirmed 5 cases of squamous cell carcinoma, 2 cases of basal cell carcinoma, and one case of adenoid cystic carcinoma. Surgical margins were negative in 5 cases. Follow-up was favorable without recurrence in six cases. In one case, a progressive disease with patient death was observed.
CONCLUSIONS: Optimal treatment requires early diagnosis and careful imaging assessment of tumor extension to tailor treatment, which often includes surgery and radiotherapy.