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Radiation induced carcinoma of the middle ear is rare. Only four cases have been reported; an additional case is now described. The treatment approach for radiation induced carcinoma of the middle ear has not yet been established. Radiation therapy for advanced cases is discussed as an alternative to surgical treatment. Previous reported cases are reviewed.
The diagnosis of basal cell epitheliomas of the face is usually made at an early stage (lesions of less than one centimetre in diameter) in France. Because of their good prognosis, without metastatic risk (95% recovery rate), therapy can be chosen as a function of its cost and the esthetic result obtained. The author considers that surgery, endocurietherapy with iridium, and plesioradiotherapy are equally effective but should be chosen according to the extent and location of the lesion. The ear, and to a lesser degree the nose, are the major indications for curietherapy. For the cyclids and flat surfaces (temporal or frontal regions etc...) surgery, and plesioradiotherapy are the treatment of choice.
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This investigation was conducted to evaluate 20 cases of implant-retained prosthetic rehabilitation (mean follow-up of 35 months). Ear, nose, orbit and complex defects of the face have been restored. Our main indication was reconstruction in cancer patients after tumor surgery (n = 14). Rehabilitation was also performed in traumatic disorders (n = 3) and congenital aural malformations (n = 3). Fifty seven titanium fixtures have been implanted with an integration success rate of 98%. We also report 6 cases of maxillary or mandibulary functional rehabilitation. The use of osteointegrated implants to provide support for maxillo-facial prosthesis is a new and valuable technique when reconstructive plastic surgery is not envisageable.
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We report a rare case of bilateral carcinoma of the ears in a 41-year-old man. The second tumor developed from the left mastoidectomized middle ear cavity eight years after the complete healing of the first tumor, which probably originated in the glands of the right external auditory canal.
We report the sixth known case of a pleomorphic adenoma of the external auditory canal. It manifested as an aural polyp, and the diagnosis was made only after microscopic pathologic examination. Complete removal was accomplished after a total parotidectomy (with preservation of the facial nerve) provided access to the parapharyngeal space surrounding the internal carotid artery, where it is postulated that the tumor originated. A thorough knowledge of the developmental anatomy of this area greatly enhances operative success.
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PURPOSE: To analyze outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. PATIENTS AND METHODS: We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas, 9 squamous cell carcinomas) of the nose, periorbital areas, and ears from 40 previously untreated patients (Group 1) and 57 patients who had undergone surgery (Group 2). The average dose was 55 Gy (range, 50-65 Gy) in Group 1 and 52 Gy (range, 50-60 Gy) in Group 2 (mean implantation times: 79 and 74 hours, respectively). We calculated survival rates and assessed functional and cosmetic results de visu. RESULTS: Median age was 71 years (range, 17-97 years). There were 29 T1, 8 T2, 1 T3, and 2 Tx tumors in Group 1. Tumors were <2 cm in Group 2. Local control was 92.5% in Group 1 and 88% in Group 2 (median follow-up, 55 months; range, 6-132 months). Five-year disease-free survival was better in Group 1 (91%; range, 75-97) than in Group 2 (80%; range, 62-90; p = 0.23). Of the 34 patients whose results were reassessed, 8 presented with pruritus or epiphora; 1 Group 2 patient had an impaired eyelid aperture. Cosmetic results were better in Group 1 than in Group 2 with, respectively, 72% (8/11) vs. 52% (12/23) good results and 28 (3/11) vs. 43% (10/23) fair results. CONCLUSIONS: Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery.
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A rare case of 3-year-old girl, presenting with aural papillomatosis, was successfully treated by surgical excision with no recurrence thereafter. Main emphasis of surgery was to avoid seeding the lesion and restructuring the external auditory canal.
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