| Object:To study the clinical manifestations,diagnosis and treatment of cancer of the external auditory canal and middle ear,improve patient survival rate,improve the quality of life.Methods:A series of 12 patients with carcinoma of the external auditory canal and middle ear treated between 1998 and 2009 in our institutions were analyzed,all patients were diagnosis based on pathology of biopsy specimens.Analysis the clinical manifestations of patients,signs,imaging,and other auxiliary examination,and we categorize the 12 cases with Still staging system.According to different stages of each patient we choose the treatment of operation with or without radiotherapy,all patients were followed up,during the follow-up time we keep the ear cavities clear,recheck CT or Miring order to reduce the recurrence cate,increase the effect of treatment,increase the probability of early detection of cancer focal recurrence.Results:In the 12 cases,including various clinical manifestations the common manifestations are hearing loss in 10 cases(83.3%),neoplasm in external auditory canal 10 cases(83.3%),suppuration in external auditory canal 9 cases(75.0%),ear pain 8 cases (66.7%),which has a history of chronic supportive obits media 9 cases(75.0%).All of the patients take temporal Cetin different stages induce the different infringement range, the common infringing parts are external auditory canal 10 cases(83.3%),middle ear tympanum 6 cases(50%),mastoid process 3 cases(25.0%).We categorize the 12 cases of patients with Still stage system:T1 has four cases,T2.has four cases and T3 have four cases.11 patients underwent surgery treatment,1 patients because of economic reasons refused to surgery.Different stages of patients take the different range of operation,we cut the carcinoma range as far as possible,surgical resection of the lesion was cutting edge,10 cases of cutting edge were negative,1 cutting edge was positive.Surgical specimens were regular send pathology.Squamous cell carcinoma in 9 cases,adenoid cystic carcinoma in 2 cases,and basal cell carcinoma in 1 case.Suggestions all patients for radiation treatment within 2 weeks after operation,due to personal reasons,5 patients did not take radiotherapy,6 patients took radiotherapy.Follow-up was performed,follow-up time ranged from 2 months to 5 years 8months,the average follow-up period is 16 months.Five patients of tumor recurrence is 3 months,4 months,7 months,15 months,20 months after operation,the five patients were 1 case of T1,1 cases of T2 and 3 cases of T3.Four of the five patients are squalors cell carcinoma,and three of them are the first time of tumor recurrence,one case is tumor recurrence and intracranial metastasis,one of the five patients is adenoid cystic carcinoma.The 5 patients after operation were without radiotherapy,three of them took the second time of operation,4 years after the operation one adenoid cystic carcinoma was discovered bilateral lung masses,it was diagnosed carcinoma metastasis by pathology of biopsy specimens.4 months after operation one patient had pain in the ear,pathology of the liquid of external auditory canal was tumor recurrence.12 months after the second operation one patient was discovered neoplasm in the external auditory canal,and the cerebral CT image discovered metastasis.2 cases in 12 patients were died during follow-up time in 14 months,34 months after operation,the rest within the follow-up time were all survive.Conclusion:Pathological examination is the gold standard in diagnosis.The treatment is based on the accurate clinical stage.The treatment of surgery combined with radiotherapy is the best treatment,regularly follow-up is a major means of early detection of recurrence after treatment,active treatment after recurrence still have certain effect.
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