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Parotidectomy in the management of squamous cell carcinoma of the external auditory canal

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To investigate optimal approaches for appropriate removal of the parotid gland in the management of squamous cell carcinoma (SCC) of the external auditory canal (EAC) at different tumor stages.

Methods

In total, 39 patients with SCC of EAC treated at the Second Affiliated Hospital of Nanchang University between September 2003 and April 2019 were enrolled in this study. All patients underwent lateral temporal bone resection or subtotal temporal bone resection. Total parotidectomy was performed in patients with direct parotid invasion. Superficial parotidectomy was performed in patients with parotid node metastasis and patients with advanced stages without evidence of parotid involvement.

Results

The mean follow-up period was 68.7 months. Local recurrences or distant metastases occurred in five patients (12.8%). The 5-year overall survival rate was 78.4%. The 5-year survival rate was 100% in early stage (T1 and T2) patients, and 58.9 and 50.0% in patients staged III and IV, respectively. Direct parotid invasion was observed in only advanced-stage patients, while parotid node metastasis was noted in both early and advanced-stage patients preoperatively. There were no significant differences (χ2 = 0.1026; p = 0.749) between different tumor primary locations. However, soft tissue or preauricular organs became vulnerable once the anterior wall was infiltrated or eroded.

Conclusion

Parotid management is important for achieving safer and wider tumor-free margins. Total parotidectomy should be mandatory for all advanced-staged (T3 and T4) patients. An optimal decision for parotid management in early stages depends on the infiltration or erosion of the anterior wall of the EAC.

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References

  1. Clark LJ, Narula AA, Morgan DA, Bradley PJ (1991) Squamous carcinoma of the temporal bone: a revised staging. J Laryngol Otol 105:346–348

    Article  CAS  Google Scholar 

  2. Morton RP, Stell PM, Derrick PP (1984) Epidemiology of cancer of the middle ear cleft. Cancer-Am Cancer Soc 53:1612–1617

    CAS  Google Scholar 

  3. Xie B, Zhang T, Dai C (2015) Survival outcomes of patients with temporal bone squamous cell carcinoma with different invasion patterns. Head Neck 37:188–196

    Article  Google Scholar 

  4. Gidley PW, DeMonte F (2013) Temporal bone malignancies. Neurosurg Clin N Am 24:97–110

    Article  Google Scholar 

  5. Paul WG, Franco D (2018) Squamous cell carcinoma and basal cell carcinoma of the ear canal and temporal bone. In: Paul WG (ed) Temporal Bone Cancer| SpringerLink. Springer, Cham, pp 83–107

    Google Scholar 

  6. Lee JM, Joo JW, Kim SH, Choi JY, Moon IS (2018) Evidence based tailored parotidectomy in treating external auditory canal carcinoma. SCI REP-UK 8

  7. Zhang T, Li W, Dai C, Chi F, Wang S, Wang Z (2012) Evidence-based surgical management of T1 or T2 temporal bone malignancies. Laryngoscope 123:244–248

    Article  Google Scholar 

  8. Ihler F, Koopmann M, Weiss BG, Dröge LH, Durisin M, Christiansen H, Weiß D, Canis M, Wolff HA (2015) Surgical margins and oncologic results after carcinoma of the external auditory canal. Laryngoscope 125:2107–2112

    Article  Google Scholar 

  9. Xie B, Zhang S, Liu Y (2019) Endoscopic-assisted repair of spontaneous temporomandibular joint herniation through a transcanal approach. Otol Neurotol 40:772–776

    Article  Google Scholar 

  10. Peach HS, van der Ploeg APT, Haydu LE, Stretch JR, Shannon KF, Uren RF, Thompson JF (2013) The unpredictability of lymphatic drainage from the ear in melanoma patients, and its implications for management. Ann Surg Oncol 20:1707–1713

    Article  Google Scholar 

  11. Rinaldo A, Ferlito A, Suarez C, Kowalski LP (2005) Nodal disease in temporal bone squamous carcinoma. Acta Otolaryngol 125:5–8

    Article  Google Scholar 

  12. Osborne RF, Shaw T, Zandifar H, Kraus D (2008) Elective parotidectomy in the management of advanced auricular malignancies. Laryngoscope 118:2139–2145

    Article  Google Scholar 

  13. Shinomiya H, Uehara N, Teshima M, Kakigi A, Otsuki N, Nibu K (2019) Clinical management for T1 and T2 external auditory canal cancer. Auris Nasus Larynx 46:785–789

    Article  Google Scholar 

  14. Moody SA, Hirsch BE, Myers EN (2000) Squamous cell carcinoma of the external auditory canal: an evaluation of a staging system. Am J Otol 21:582–588

    CAS  PubMed  Google Scholar 

  15. Homer JJ, Lesser T, Moffat D, Slevin N, Price R, Blackburn T (2016) Management of lateral skull base cancer: united Kingdom National multidisciplinary guidelines. J Laryngol Otol 130:S119–S124

    Article  CAS  Google Scholar 

  16. Zanoletti E, Marioni G, Stritoni P, Lionello M, Giacomelli L, Martini A, Mazzoni A (2014) Temporal bone squamous cell carcinoma: analyzing prognosis with univariate and multivariate models. Laryngoscope 124:1192–1198

    Article  Google Scholar 

  17. Park JM, Kong JS, Chang KH, Jun BC, Jeon EJ, Park SY, Park SN, Park KH (2018) The clinical characteristics and surgical outcomes of carcinoma of the external auditory canal: a multicenter study. J Int Adv Otol 14:278–284

    Article  Google Scholar 

  18. Chi FL, Gu FM, Dai CF, Chen B, Li HW (2011) Survival outcomes in surgical treatment of 72 cases of squamous cell carcinoma of the temporal bone. Otol Neurotol 32:665–669

    Article  Google Scholar 

  19. Mazzoni A, Danesi G, Zanoletti E (2014) Primary squamous cell carcinoma of the external auditory canal: surgical treatment and long-term outcomes. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 34:129–137

    CAS  Google Scholar 

  20. Leong SC, Youssef A, Lesser TH (2013) Squamous cell carcinoma of the temporal bone: outcomes of radical surgery and postoperative radiotherapy. Laryngoscope 123:2442–2448

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank Editage (www.editage.cn) for English editing.

Funding

This work was supported by grants from the National Natural Science Foundation of China (81660173), and the Science and Technology Program of Health and Family Planning Commission of Jiangxi Province (20175234).

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, Jiangxi Province, China

    Bingbin Xie, Meiqun Wang, Shaorong Zhang & Yuehui Liu

  2. Jiangxi Biomedical Engineering Research Center for Auditory Research, Nanchang, 330006, China

    Bingbin Xie, Meiqun Wang, Shaorong Zhang & Yuehui Liu

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  1. Bingbin Xie
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  2. Meiqun Wang
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  3. Shaorong Zhang
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Correspondence to Yuehui Liu.

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Xie, B., Wang, M., Zhang, S. et al. Parotidectomy in the management of squamous cell carcinoma of the external auditory canal. Eur Arch Otorhinolaryngol 278, 1355–1364 (2021). https://doi.org/10.1007/s00405-020-06191-5

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  • DOI: https://doi.org/10.1007/s00405-020-06191-5

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