Cancer of the Auditory Canal

Author’s address: J. Kuilman, M. D., Surinamestraat 19, Den Haag (Netherlands) Carcinoma of the ear is a rare condition. According to Lewis (2) “even a busy otolaryngologist may see, at most, only one or two ear cancers in his entire career”. Robinson (3) found a diagnosis of tumour in a survey of 48 cases among 212,000 cases of aural disease, seen between 1905 and 1924 at the Manhattan Eye, Ear and Throat Hospital. At the Massachusetts’ Eye and Ear Infirmary (4) only 15 patients out of 90,000 ear cases had neoplasms. According to a study of Broders (1), the tumour may be localised in the auricle (84%), auditory meatus (12%) or middle ear and mastoid (1.5%). Also, in other surveys the general opinion is that among malignant epitheliomas of the ear the auricle is involved in the majority of cases, the meatus in 10 to 20% only. The therapeutic approach, irradiation, surgery or both, differs according to localisation, pathological type and extension of the tumour. The present case, E. J. K., a 75-year-old man, was seen on 20. 8. 1960 complaining of pain and slight swelling of the left auditory canal. On otoscopy a normal eardrum and normal hearing was found, and the clinical appearance of an external otitis, except for a tiny piece (+ 1 mm3) of granulation-like tissue originating from a excoriation 5 mm. inside the orifice, was found. On histological examination 1 the biopsy was diagnosed as an adenoid basal cell carcinoma.. Therapy consisted of irradiation with radium given by Dr. Scholte \ The problem of how to keep the radium needle fixed in the right position in the meatus during treatment was solved by making a polythene earpiece similar to those used in connection with hearing aids (vide fig.). 1 I am much indebted to Dr. P. M. Bakker (Pathological Department of the Municipal Hospital, The Hague) for this microscopical examination of the biopsy and to Dr. P. J. L. Scholte (Radiotherapeutical Department of the Municipal Hospital) who performed the radiotherapy. ]20 Kuílman, Cancer of the Auditory Canal