Cancer in the ear has a broad classification of major class called as head and neck cancer. The evaluation of otorrhea is the major stake for any such new or neoplasms that one may want to explore or exclude from other diagnosis.
Otorrhea means drainage of liquid from the ear and results from external ear canal pathology or middle ear disease with tympanic membrane perforation.
Cancer is a rare cause of otorrhea but should be considered in patients with abnormal tissue growth in the ear canal or a lack of response to prolonged external otitis treatment. These patients warrant prompt referral to an ear, nose, and throat (ENT) specialist with pediatric expertise.
Ear canal cancer occurs far less frequently than auricular cancer, although the presentation and behavior are more sinister. In the early stages it is often indistinguishable from external otitis. In addition, rhabdomyosarcoma and neuroblastoma may manifest as auditory canal tumors in children.
Otorrhea may often caused by one of several more benign diseases. Clinical findings with cleansing of debris will differentiate among most of these etiologies.
Malignant external otitis (also termed necrotizing external otitis) is a severe, potentially fatal complication of acute bacterial external otitis. Most common in elderly diabetic patients or other immunocompromised individuals, it occurs when the infection spreads from the skin to bone and marrow spaces of the skull base (also involving soft tissue and cartilage of the temporal region).
Patients typically have severe otalgia and otorrhea with pain that appears out of proportion to examination findings. Granulation tissue at the bony cartilaginous junction of the ear canal floor is a classic finding. Edema, erythema, and frank necrosis of ear canal skin may be evident. Cranial nerve palsies are a poor prognostic sign. Patients generally have a markedly elevated erythrocyte sedimentation rate (ESR). Diagnosis is aided with an abnormal MRI or CT scan showing extension of infection into bony structures. Patients who may have malignant external otitis should be promptly referred to an otolaryngologist.
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