[A retrospective analysis of surgical operations on malignancies of the ear]

In the past 20 years from 1970 to 1990, 21 patients with malignancies of the ear were treated at Cancer Institute Hospital. The primary sites were the auricle and cartilaginous external auditory canal (group 1: n = 8), the bony external auditory canal (group 2: n = 6) and the middle ear (group 3:n = 7). In group 1, pathological types were squamous cell carcinoma in four patients and basal cell carcinoma in the other four patients. Seven patients were treated by surgery alone, and the remaining patient was treated by interstitial implant radiotherapy. No recurrence have been noted up to today in this group. In group 2, pathological types were squamous cell carcinoma in four patients and adenoid cystic carcinoma in the other two patients. All of the six patients underwent external canal resection or subtotal temporal resection. Two patients received postoperative radiotherapy. A five year survival rate of group 2 was 60%. In group 3, pathological types were squamous cell carcinoma in six patients and undifferentiated carcinoma in the remaining patient. Most of them underwent radical mastoidectomy followed by irradiation. However, all the patients died within two years after treatment. In group 2 and 3, cytodiagnosis was useful for early discovery. In group 2, temporomandibular joint seemed to be a key point in surgical treatment. In group 3, the combination of conservative surgery with radiotherapy was not a radical treatment. This suggested it necessary to perform subtotal temporal resection to treat malignancy of the middle ear.