The ear
Rogan J Corbridge in Essential ENT, 2011
Tumours of the facial nerve itself are rare. The nerve, however, can be involved by a tumour anywhere along its course: Parotid gland: VII nerve palsy usually indicates a malignant lesion.External and middle ear: malignant lesions such as squamous cell carcinoma.CPA: acoustic neuroma, glomus tumours, etc.Petrous bone: cysts, secondary carcinomas.
External Ear
James R. Tysome, Rahul G. Kanegaonkar in Hearing, 2015
It generally starts with a simple otitis externa and the causative organism is usually Pseudomonas aeruginosa. It almost exclusively affects patients with diabetes or another cause of immunosuppression, and should be suspected in any such patient in whom the infection proves difficult to control or if severe otalgia persists despite apparent clinical resolution of infection. Weakness of the lower cranial nerves often occurs, particularly the facial nerve. Treatment is best planned jointly with a microbiologist and usually requires a prolonged course of antibiotics, often initially intravenous for around 6 weeks followed by oral for several months. MRI is usually the best imaging modality, although resolution on imaging generally lags behind clinical resolution. A biopsy of external ear canal granulation tissue should be taken in order to exclude a squamous cell carcinoma, which may present with a similar clinical picture.
Sinus and Ear Infections in the Elderly
Thomas T. Yoshikawa, Shobita Rajagopalan in Antibiotic Therapy for Geriatric Patients, 2005
A high index of suspicion is necessary to make this diagnosis with early involvement of an otolaryngologist. Blood analysis often reveals a normal white blood cell (WBC) count with an altered differential. The erythrocyte sedimentation rate (ESR) is often elevated and can be used to monitor the infection and response to antibiotics. Radiologically, CT and magnetic resonance imaging (MRI) scans have been used in addition to gallium-67 (Ga-67), bone and single photon emission computed tomography (SPECT) scans (19). The CT scan of the temporal bone with contrast is used to determine bony erosion and extension into the petrous apex; this may be negative early in the disease process. An MRI scan with gadolinium is useful to determine soft tissue (periauricular and parotid) and bone marrow involvement. Absorption of Ga-67 directly into granulocytes and bacteria allows for early detection and monitoring of the disease as it reverts to normal once the acute infectious process is controlled. This is often complemented by a technetium-99 bone scan which is absorbed at the sites of osteoblastic activity but remains persistently positive. The performance of the combined Ga-67-SPECT scan has increased sensitivity over the gallium scan alone. Biopsy of the granulation tissue is necessary to exclude aural malignancies (squamous cell carcinoma or metastatic carcinomas), which may also present as a chronic draining ear.
miR-34a predicts the prognosis of advanced-stage external auditory canal squamous cell carcinoma
Published in Acta Oto-Laryngologica, 2022
Naotaro Akiyama, Tomomi Yamamoto-Fukuda, Hiromi Kojima
Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is a rare disease, accounting for less than 0.2% of head and neck SCC, and the prognosis is poor in advanced cases [1,2]. Surgery is the mainstay curative treatment for EACSCC [1,2]. Radiotherapy is effective as adjuvant therapy but is not established for low-stage tumors or as a primary treatment [1,2]. The value of chemotherapy is also still unclear. Although early diagnosis is crucial for prompt treatment, the early signs and symptoms are nonspecific and difficult to distinguish from otitis externa [1,2]. Local aggressiveness and anatomical complexity cause a poor prognosis in advanced EACSCC [1,2]. Radiological imaging (computed tomography and magnetic resonance imaging) sometimes underestimates the tumor extent and is unable to detect microscopic diffusion [2]. Furthermore, postoperative pathological findings show heterogeneity and there are no promising biomarkers available for early diagnosis and prognostic determinants for EACSCC [1,2]. The purpose of this study is to identify the molecular markers involved in the clinical behavior and prognosis of EACSCC. The future goal is to identify novel therapeutic targets and improve the prognosis of EACSCC.
Exosomes in head and neck cancer. Updating and revisiting
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2019
Samuel Rodríguez Zorrilla, Abel García García, Andrés Blanco Carrión, Pilar Gándara Vila, Manuel Somoza Martín, Mercedes Gallas Torreira, Mario Pérez Sayans
The most frequent type of head and neck cancer is squamous cell carcinoma (SCC), which accounts for more than 90% of cancers of the head and neck1. One of the primary locations where this disease manifests is in the oral cavity; however, it occurs frequently in the pharynx and larynx as well2. Oral cancer is the sixth most commonly diagnosed cancer in the world and was responsible for 145, 000 deaths in 2012, 77% of which happened in regions with a poor economic development3. Oral squamous cell carcinoma represents 90% of all oral cancer varieties with a very common lymph node involvement4. The five-year survival rate for patients with localised oral squamous cell carcinoma is higher than 80%, however this rate drops dramatically to 40% when the lymph nodes are involved, and to 20% for patients with distant metastasis5.
Factors that affect survival in vaginal cancer: a seer analysis
Published in Journal of Obstetrics and Gynaecology, 2022
Batuhan Bakirarar, Muberra Namli Kalem, Ziya Kalem
It is a natural outcome that survival time is longer in the presence of in situ vaginal cancer compared to invasive cancer. In the case of in situ cancer, survival time can be maintained using local surgical or ablative methods depending on patient’s overall medical condition, and lesion’s histological type and localisation (Hacker et al. 2015). Since such lesions are closely followed up, survival is longer compared to a primary invasive tumour once there is a transition to the invasive period (Dittmer et al. 2011). In a research covering the years 1996–2003, for in situ cases of vaginal squamous cell carcinoma, 5-year survival rate was 95.6% whereas it varied between 63.9% and 75.8% for invasive cases in connection with stage (Wu et al. 2008). Wolfson et al. (2016) showed in a SEER analysis that prognosis worsened with larger tumour diameter, but they excluded the insitu stage.
Related Knowledge Centers
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- Gastrointestinal Tract
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- Respiratory Tract
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- Vaginal Cancer
- Cancer
- Cutaneous Squamous-Cell Carcinoma
- Squamous-Cell Carcinoma of The Lung
- Squamous-Cell Carcinoma of The Vagina