Advertisement

Management of the Parotid Gland in Cutaneous External Auditory Canal Skin Cancer

  • Sobia KhajaEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Cutaneous squamous cell carcinoma of the external auditory canal is a rare tumor, presenting with nonspecific symptoms. Any nodal disease in patients with temporal bone malignancies places the patient in stage IV category within the modified Pittsburgh staging system. Management of the nodal basin for these patients remains controversial. A MEDLINE and PubMed search was performed comparing a parotidectomy with observation for patients with cutaneous malignancies of the EAC. Results of the search was largely limited to retrospective chart reviews with low quality evidence containing a limited number of patients largely secondary to the rare nature of the disease process. These articles are summarized and reviewed. Few studies directly compared observation to parotidectomy resulting in need for indirect conclusions to be made to answer the proposed question. The studies provide low quality evidence for the conditional weak recommendation of performance of an elective parotidectomy in management of malignancies of the external ear canal. Nodal disease is a negative prognostic indicator and a parotidectomy may assist with staging and prognosis, allow for obtaining soft tissue margins, and providing control of the facial nerve with limited increase in morbidity.

Keywords

Squamous cell carcinoma Ear canal cancer Parotidectomy External auditory canal cancer Temporal bone carcinoma 

Notes

Acknowledgements

Special thanks to Sarah Jane Brown, M.Sc. for assisting with the literature search.

References

  1. 1.
    Gidley PW, DeMonte F. Temporal bone malignancies. Neurosurg Clin N Am. 2013;24(1):97–110.CrossRefGoogle Scholar
  2. 2.
    Lobo D, Llorente JL, Suarez C. Squamous cell carcinoma of the external auditory canal. Skull Base. 2008;18(3):167–72.CrossRefGoogle Scholar
  3. 3.
    Gidley PW, Roberts DB, Sturgis EM. Squamous cell carcinoma of the temporal bone. Laryngoscope. 2010;120(6):1144–51.PubMedGoogle Scholar
  4. 4.
    Homer JJ, Lesser T, Moffat D, Slevin N, Price R, Blackburn T. Management of lateral skull base cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2):S119–24.CrossRefGoogle Scholar
  5. 5.
    Cristalli G, Manciocco V, Pichi B, Marucci L, Arcangeli G, Telera S, Spriano G. Treatment and outcome of advanced external auditory canal and middle ear squamous cell carcinoma. J Craniofac Surg. 2009;20(3):816–21.CrossRefGoogle Scholar
  6. 6.
    Morris LG, Mehra S, Shah JP, Bilsky MH, Selesnick SH, Kraus DH. Predictors of survival and recurrence after temporal bone resection for cancer. Head Neck. 2012;34(9):1231–9.CrossRefGoogle Scholar
  7. 7.
    Lassig AA, Spector ME, Soliman S, El-Kashlan HK. Squamous cell carcinoma involving the temporal bone: lateral temporal bone resection as primary intervention. Otol Neurotol. 2013;34(1):141–50.CrossRefGoogle Scholar
  8. 8.
    Zhang T, Li W, Dai C, Chi F, Wang S, Wang Z. Evidence-based surgical management of T1 or T2 temporal bone malignancies. Laryngoscope. 2013;123(1):244–8.CrossRefGoogle Scholar
  9. 9.
    Choi JY, Choi EC, Lee HK, Yoo JB, Kim SG, Lee WS. Mode of parotid involvement in external auditory canal carcinoma. J Laryngol Otol. 2003;117(12):951–4.CrossRefGoogle Scholar
  10. 10.
    Spector JG. Management of temporal bone carcinoma: a therapeutic analysis of two groups of patients and long-term followup. Otolaryngol Head Neck Surg. 1991;104(1):58–66.CrossRefGoogle Scholar
  11. 11.
    Kunst H, Lavielle JP, Marres H. Squamous cell carcinoma of the temporal bone: results and management. Otol Neurotol. 2008;29(4):549–52.CrossRefGoogle Scholar
  12. 12.
    Zanoletti E, Danesi G. The problem of nodal disease in squamous cell carcinoma of the temporal bone. Acta Otolaryngol. 2010;130(8):913–6.CrossRefGoogle Scholar
  13. 13.
    Mazzoni A, Danesi G, Zanoletti E. Primary squamous cell carcinoma of the external auditory canal: surgical treatment and long-term outcomes. Acta Otorhinolaryngol Ital. 2014;34(2):129–37.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Zanoletti E, Marioni G, Stritoni P, Lionello M, Giacomelli L, Martini A, Mazzoni A. Temporal bone squamous cell carcinoma: analyzing prognosis with univariate and multivariate models. Laryngoscope. 2014;124(5):1192–8.CrossRefGoogle Scholar
  15. 15.
    Gidley PW, Thompson CR, Roberts DB, DeMonte F, Hanna EY. The oncology of otology. Laryngoscope. 2012;122(2):393–400.CrossRefGoogle Scholar
  16. 16.
    Oya R, Takenaka Y, Takemura K, Ashida N, Shimizu K, Kitamura T, Yamamoto Y, Uno A. Surgery with or without postoperative radiation therapy for early-stage external auditory canal squamous cell carcinoma: a meta-analysis. Otol Neurotol. 2017;38(9):1333–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology—Head and Neck SurgeryUniversity of MinnesotaMinneapolisUSA

Personalised recommendations