A 60-year-old man presents with otalgia, blood-stained discharge from the ear, and a granulation tissue in the external auditory canal. Biopsy shows squamous cell carcinoma. CT shows erosion of the bony external auditory canal but no parotid involvement. What is the recommended surgical treatment?
- A Lateral temporal bone resection ✓
- B Local excision of the granulation
- C Total temporal bone resection
- D Radiotherapy alone
Explanation
Squamous cell carcinoma of the external auditory canal with bony erosion requires lateral temporal bone resection (en bloc resection of the ear canal, tympanic membrane, malleus, and incus). This is the standard surgical approach for tumors confined to the ear canal without extensive temporal bone involvement. Total temporal bone resection is reserved for extensive tumors involving the petrous apex. Local excision alone is inadequate for malignant disease. Radiotherapy alone is generally not curative for resectable temporal bone SCC, though it may be used as adjuvant therapy.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
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Written and medically reviewed by the StethoPrep medical team.