Cancer in the middle ear and the auditory canal

Thirty-seven patients with malignant tumours in the ear treated at Rigshospitalet, Copenhagen in the period 1.6.1983-1.6.1993 were retrospectively reviewed. There were 20 males and 17 females. The average age was 67 years. Twenty-four patients had tumours involving the middle ear and 13 patients had tumours located only in the external auditory canal. Eighty-four percent had squamous cell carcinoma. In 61% of the patients with squamous cell carcinoma, chronic infection of the ear preceded the malignant process. Overall control of disease for the 37 patients was 49%. The total actuarial crude survival was 33%. For the nine patients who had squamous cell carcinoma located only in the external auditory canal, the control of disease was 89%. Twenty-two patients had squamous cell carcinoma involving the middle ear. Most of these patients underwent radical mastoidectomy and step-wise removal of gross tumour followed by radiotherapy. Six had radiotherapy alone. The control of disease in this group was 32%. It is concluded that tumours involving only the external auditory canal have a good prognosis. If the tumour involves the middle ear, the prognosis falls dramatically.