External auditory canal neoplasms comprise less than 1 percent of all head and neck tumors. They are ceruminous gland-originated tumors in 2.4 percent of cases. In the past, all these tumors were called ceruminomas. In 1972 Wetli et al. classified these neoplasms into four groups: ceruminous adenomas, ceruminous carcinoma, adenoid cystic carcinomas, and pleomorphic adenomas. Ceruminous adenocarcinoma is very rare. It has no specific symptoms, therefore, an appropriate, quick diagnosis is difficult; it is very aggressive. Treatment should be based on tumor resection and followed by radiotherapy. We presented a case of a 56-year-old female with a lump in the external ear canal, who underwent diagnostic surgical excision of the tumor in the external auditory canal. The postoperative histopathological diagnosis was ceruminous adenocarcinoma (complete excision) and the patient received radiation therapy. Follow-up CT and MR – performed one year after surgery - showed a possible local recurrence of pathology. The patient underwent maximal surgical resection with subtotal petrosectomy but postoperative histological examination showed no malignant cells. Treatment of external auditory canal neoplasms should be based on radical surgical resection. Diagnostic imaging is very important in follow up examination but it can have limited value in terms of its specificity.
Introduction: Foreign bodies of the external auditory canal are common pathology in otolaryngological practice. Complains that accompany this pathology depends on the nature of the foreign body and the time of retention. Because of the potential for serious complications to this seemingly prosaic pathology, reacting as quickly as possible is crucial. Case report: Below we describe an example of a long-standing foreign body in the external auditory canal, we present ways of dealing with the problem and potential complications that may be associated with it.
Carcinoma of the external auditory canal (EAC) is known to be very rare with a rate of 1-6 per million people. It affects mostly people over the age of 50 regardless of gender. The most common type of carcinoma of EAC is squamous cell carcinoma (SCC). The aim of this paper is to present the case of a 56-year-old woman with carcinoma of EAC. She was admitted to otolaryngology clinic due to ear buzzing lasting for five months, periodic otorrhea and hearing deterioration in her right ear. In otoscopic examination a tumor in the right ear meatus was identified. It filled almost the entire canal. Biopsy confirmed the presence of squamous-cell cancer. Tumor advancement was diagnosed using computer tomography of the temporal bones, magnetic resonance imaging of the head and ultrasonography of the neck. Imaging examinations indicated T3 N0 stage. Doctors decided to perform lateral petrosectomy with elective neck dissection. During the operation, the results of histopathological examination of frozen specimens from marginal tissues revealed an invasion of the anterior wall of the ear canal, capsule of temporomandibular joint and parotid gland. The resection eventually included also parotid gland and temporo-mandibular joint with the caput of the mandible. After recuperation, the patient had complementary radiotherapy. The presented case shows that precise imaging is necessary before surgical treatment, but unfortunately the invasion of cancer may not be estimated properly. Based on literature, the best prognosis concerns wide resection with complementary radiotherapy, although the schedule of treatment is not determined.
We present a surgical technique of closed tympanoplasty for chronic otitis, together with an intraoperative functional evaluation system with the OssiMon LAIOM software. The technique can be used in one or two steps for an intraoperative evaluation of the functional effect during ear operation. Using OssiMon LAIOM, we were able to simultaneously measure the auditory steady-state response (ASSR), as well as to perform laser dopler vibrometry (LDV). For electrophysiologic measurements, OssiMon LAIOM uses the Intelligent Hearing System platform, and the Polytec single-point laser to evaluate the ossicular mobility. The measurements can be conducted using both methods at the same time or separately, applying each method independently. The OssiMon LAIOM software records the ASSR response intraoperatively and marks it automatically on the audiogram with the preoperative hearing level. The ossicular vibration level is determined based on the measured LDV response. To the best of our knowledge, OssiMon LAIOM is the first solution allowing to objectively measure the effectiveness of tympanoplasty using two methods simultaneously, i.e. ASSR and LDV. The system could be widely applied in the functional evaluation of the middle ear and in clinical practice.
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