Ear tumor

Ear tumor
An ear tumor is an education that occurs in people of mature or advanced age, but the exception is sarcoma, which is observed mainly in children. The prevalence among women and men suffering from an ear tumor is the same. The only exception is cancer of the auricle, which is 4 times more common in men than women. Usually, an ear tumor is located near or in the auricle, as well as in the ear canal. The appearance of a tumor in the middle ear is a rare phenomenon. If we talk about tumors of the inner ear, then these are rather casuistic cases, which are presented in the form of a metastatic lesion.

The content of the article:
Types of malignant ear tumor
Causes of ear tumors
Symptoms of an ear tumor
Diagnosis of an ear tumor
Treatment of ear tumors
Prognosis for ear tumors
Ear tumor
Types of malignant ear tumor
Any malignant tumor has a primary and secondary character. Researchers distinguish three types of malignant tumor: infiltrative, solitary vegetative and ulcerative. According to its histological structure, a malignant tumor of the ear has the form of a spinocellular epithelioma and, in rare cases, basal cell carcinoma. However, the rarest case is the manifestation of a malignant tumor of the ear in the form of sarcoma. Let’s now consider each type in more detail:

Spinocellular epithelioma. This type of malignant tumor is distinguished by its rapid growth. If such a tumor is localized on the auricle, then it acquires a warty appearance, having a wide base that will bleed with the most minor injury. If such a tumor is located in the auditory canal, it will be presented as a kidney-shaped outgrowth (or erosion) or a diffuse process that covers the entire auditory canal;
Basal cell carcinoma of the ear. This type of malignant tumor is characterized by slow growth and a later process of metastasis. If such a tumor is located on the auricle, then its appearance will look like an ulcer or a flat scar. If the localization of the basal cell carcinoma is located at the site of attachment of the auricle to the skull, then this may cause its partial (or complete) amputation.
Sarcoma of the auricle. This type of malignant tumor is characterized by a slow course and a later manifestation. As for the sarcoma of the auditory canal, on the contrary, it will grow quite intensively, quickly spreading into the middle ear cavity.
Causes of ear tumors
If we talk about the occurrence of a benign ear tumor, then its origin is explained by the action of provoking factors, due to which there is a rapid growth and reproduction of cells in the outer or middle ear (this may be skin, cartilage, bones, fatty tissue under the skin, vascular walls, nerve trunk membranes, and so on). As for the development of malignant tumors of the ears, this phenomenon is explained by the process of malignant metaplasia of the same elements. In addition, malignant tumors can be a consequence of the transformation of benign formations in the ear cavity.

Among the factors that provoke the growth of an ear tumor, otolaryngologists distinguish the following: the presence of acute and chronic radioactive exposure, excessive exposure to ultraviolet rays, possible ear injuries, developing chronic inflammation in the ear. According to statistics, about 80% of all malignant tumors located in the ear are explained by the presence of previous diseases. If we are talking about the outer ear, then such “precursors” for it are eczema, psoriasis, lupus erythematosus, scar-like changes that have arisen after otitis media. For the middle ear, first of all, such a previous disease will be otitis media and adhesive otitis media. This can also include chronic epithympanitis. The appearance of the tumor is also affected by multiple quenching of granulations with a solution of silver nitrate. Sometimes a malignant tumor in the ear can develop even from mesenchymal tissue that has remained in the supramental space of a newborn.

Symptoms of an ear tumor
Symptoms of a benign ear tumor
As you know, a benign tumor can have the form of fibroids, papillomas, chondromas, lipomas, ostenomas and can be a nevus. Also, doctors refer to benign formations as a glomus tumor, hemangioma and neurinoma. Most often, a benign tumor occurs in the outer ear. The tumor that is located on the auricle, as a rule, is characterized by very slow growth and its asymptomatic course. Pain syndrome can occur only if the ear tumor is located on the upper edge of the curl of the auricle itself. The pain syndrome is especially noticeable here for the reason that this area is the most sensitive. Those tumors in the ears that are localized on the surface of the external auditory canal often block the lumen, thereby leading to a violation of the transmission of sounds and the further development of hearing loss.

If the ear tumor is located near the eardrum, then as it grows, the compression of the eardrum by the tumor will occur. This process is usually accompanied by a characteristic noise in the ear and a noticeable hearing loss.

As the statistics of otolaryngologists show, benign ear tumors that have arisen in the middle ear are very, very rare. Over time, having increased in size, such tumors press on the eardrum, limiting the movement of the auditory ossicles. The latter leads to a characteristic hearing loss. It should also be noted that an ear tumor can exert pressure from the tympanic cavity on the vestibule of the labyrinth, causing various vestibular disorders, which can manifest as attacks of dizziness, the appearance of nystagmus, imbalance and autonomic dysfunction. If the tumor is located close to the bulb of the jugular vein, then a blowing noise appears in the ear over time, which also has a pulsating character.

It should be known that some benign tumors (for example, a glomus tumor of the middle ear), in fact, are not such, since they have a predisposition to rapid growth, which leads to partial or complete destruction of the eardrum, as well as the walls of the tympanic cavity. The result of this is the growth of the tumor into a neighboring formation located nearby. This may be germination into large vessels, into the cranial cavity or into the inner ear. At the same time, the clinical picture of such a tumor is very similar to the clinic of malignant formation. In case of destruction of the tympanic membrane, the otolaryngologist can clearly see all the tumor masses, while, as a rule, a discharge of a bloody nature is released from the ear. If an ear tumor grows into the auditory tube or nasopharynx, then a process occurs that is very similar to the germination of a benign pharyngeal tumor. If the ear tumor spreads to the posterior cranial fossa, this will lead to damage to a number of cranial nerves with the further development of neuropathic laryngeal paresis, as well as impaired swallowing and phonation.

Symptoms of a malignant ear tumor
The symptoms of an ear tumor, and even more so its malignant form, are primarily expressed by pain syndrome. The pain, as a rule, has a baking and burning hue, resembling the pain of a burn. At first, such pain occurs only once, then repeats with enviable regularity and, eventually, becomes permanent. It is the pain syndrome that is the main sign of the incessant intensive growth of a malignant ear tumor. Almost always, the patient feels the irradiation of pain in the temporal lobe. A patient suffering from a malignant tumor in the ear is faced with constant discharge from the ear, having a purulent-bloody nature. If an ear tumor closes the auditory canal, then this leads to the development of hearing loss in the patient.

If the malignant tumor is located in the tympanic cavity, then the clinical picture will be almost the same as in chronic purulent otitis media: tinnitus, increasing hearing loss, which leads to final deafness, pain syndrome. It is the discovery of a sharp hearing loss and a constant incessant pain syndrome that can lead the patient to think about the presence of a malignant tumor. It should be said about the special nature of pain in a malignant tumor of the ear. Such pain has a deep character and is constant, intensifying at night. Even when there is abundant discharge from the ear cavity, the unbearable pain does not stop for a minute, but on the contrary, only increases.

Another symptom of a malignant tumor is a vestibular disorder. The latter is due to the fact that a malignant tumor, spreading to the area of the windows, begins to put pressure on them.

A common symptom of a malignant tumor is facial nerve paresis, and all because as the tumor grows, it destroys the facial canal, which leads to the appearance of facial nerve paresis. An increase in regional lymph nodes, as well as a thickening of the parotid glands are another characteristic symptoms of the presence of this ailment in humans.

Often, a malignant tumor can grow into the latticed bone, nasopharynx or cranial cavity. If a tumor germinates into the cranial cavity, then the trunks of the cerebellar angle will be affected first, the symptoms of which will be trigeminal neuralgia, as well as possible neuritis of the cochlear nerve or facial nerve paralysis.

Diagnosis of an ear tumor
Diagnosis of a benign ear tumor
If the ear tumor is located on the auricle, then the diagnosis is carried out not only by an otolaryngologist, but also by a dermatologist and a dermatologist. In order to determine the extent of the ear tumor, dermatoscopy is usually used or ultrasound of the formation is performed. With the help of siascopy, it will be possible to study the pigment formations present. Doctors can also send the patient for cytological examination of a smear taken from the surface of the ear tumor.

If the ear tumor is localized in the external auditory canal, then the diagnosis is made based on the results of otoscopy. It is otoscopy that can reveal the bulge of the eardrum, which will serve as a sure sign of the presence of an ear tumor in the tympanic cavity. It should also be added that with a hemangioma, there may be a translucence of the formation through the eardrum itself. Usually such an education has a bluish or, on the contrary, red color. To determine the extent of the ear tumor, either pharyngoscopy or microlaryngoscopy is usually performed.

With the help of an X-ray or CT scan of the skull, it is possible to detect the presence of a benign tumor in the temporal bone area, thanks to the detection of the destroyed bone walls of the tympanic cavity itself. Also, MRI angiography of the brain is often used as a diagnosis.

Diagnosis of a benign tumor in the ear will not be complete unless a hearing study is conducted. The latter includes the study of hearing with a tuning fork, as well as audiometry and threshold audiometry. It is such studies that will help to identify the presence of conductive type of hearing loss in patients.

If the tumor spreads into the structures of the labyrinth, the doctor can determine the type of hearing loss, which often turns out to be mixed. With the help of acoustic impedancometry, in the case of a tumor-affected middle ear, it is possible to detect impaired mobility of the auditory ossicles. Such violations will indicate that the inner ear was also involved in this process.

As for the biopsy, it is needed if all previous diagnostic methods were difficult and did not give a final result. Usually, such a histological examination is carried out on a previously removed formation from the ear cavity, which serves as the material for the study.

If we talk about the differential diagnosis of a benign tumor, then it is usually carried out together with malignant formations (for example, skin cancer, melanoma or basal cell carcinoma), as well as with foreign bodies in the ear.

Diagnosis of malignant ear tumor
The easiest way to diagnose that malignant tumor, which is located on the auricle. An otolaryngologist can make an initial conclusion on the appearance of the formation, as well as on whether it bleeds and how tightly it has fused with the located tissues. But the final diagnosis will be made only as a result of histological examination.

A tumor located in the auditory canal is usually diagnosed by otoscopy. It is otoscopy that is able to detect the presence or absence of a common ulcer, which is usually colored dark red. When probing the very bottom of such an ulcer, it is possible to determine the degree of loosening of the cartilage tissue or bone surface.

With the help of microtoscopy, it is possible to determine how much the tumor process has spread to the outer ear. In the case of a malignant formation of the middle ear, otoscopy will help to identify all possible changes that have occurred on the side of the eardrum, determining how much it is convex or torn by a tumor.

It is very difficult to diagnose a tumor in the tympanic cavity and it is possible only when the formation begins to spread to the surrounding structures. Suspicion of a malignant tumor is usually detected even with an X-ray of bone destruction, which is clearly different from the nature of the usual chronic otitis media.

The degree of prevalence of an ear tumor can be determined based on the results of a CT scan of the skull or an MRI of the brain.

Treatment of ear tumors
Treatment of a benign ear tumor
Treatment of a benign tumor of the outer ear consists in its removal, whether for cosmetic purposes or as a prevention of malignancy, or if its location is the external auditory canal. It is possible to remove the tumor both surgically and using advanced methods, for example, laser or radio wave removal. Of course, there is a risk in removing the tumor. For example, removal of a hemangioma is always dangerous because severe bleeding can open, so in this case it is best to go by electrocoagulation. If we are talking about a vascular tumor, then it can be removed in several stages, before doing sclerotherapy, ligation of the external carotid artery and X-ray therapy.

Doctors advise removing most types of benign tumors immediately. Such a rush can be explained by the fact that a benign tumor contributes to hearing impairment and can cause the formation of a malignant tumor. The only exceptions are osteomas, which differ in their slow development with the ability to stop their own growth. They are usually removed only if the doctor detects a functional disorder on the part of the hearing aid. If a benign tumor does not extend beyond the boundaries of the tympanic cavity, then it is removed by tympanotomy or atikoantrotomy.

Treatment of malignant ear tumor
The first and main way to treat a malignant tumor is to eliminate it by performing a radical operation. During the operation, not only the tumor is removed, but also all the anatomical structures of the ear affected by it. The cervical or submandibular lymph nodes and the parotid gland are also removed. Surgical intervention will not be performed only if the tumor has germinated into vital structures or if there are already metastases.

Radiation therapy or chemotherapy will be of great importance in the treatment. Such types of treatment are effective palliative therapy or part of combination therapy, which is usually carried out even before surgery.

Prognosis for ear tumors
If we talk about a benign ear tumor, then in most cases it has a favorable prognosis for both life and recovery after treatment has been carried out. The only exceptions are those vascular tumors that grow through important anatomical structures, and if not removed in a timely manner, they can transform into malignant formations.

Another thing is a malignant tumor, which always has a serious and often disappointing prognosis. Since the diagnosis of malignant formations is very difficult at the initial stage, it can be extremely difficult to identify and cure the disease immediately. A spreading malignant tumor usually leads to the death of the patient. It happens from cancerous cachexia, meningitis, complications from the central nervous system or arrosive bleeding.

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