Cysts and Tumours in the Ear
The parts of the ear are rarely affected by malignant tumours; none of the tissues in the ear regenerate continuously, apart from the skin on the surface. Cancerous tumours typically form in tissue in which the cells are dividing very rapidly, such as the lining of the digestive system, the lungs or the reproductive system. Tumours also tend to affect tissues and organs that are under the influence of hormones, such as the breast and prostate gland. The components of the ear fall into none of these groups.
What Type of Ear Tumours Are There?The most common sites for ear tumours are the skin on the surface of the pinna of the ear and the middle ear. Tumours on the pinna are usually skin cancers rather than ear tumours, although benign ear cysts can form on any part of the outer ear. The most common type of tumour in the outer ear or in the middle ear or ear canal tend to be squamous epithelial cell cancers.
Cancerous tumours that grow inside the middle ear are given the medical names glomus jugulare and glomus tympanicum; these develop inside the cavity in the middle ear but as they grow, they displace the tiny bones, the anvil, hammer and stirrup that pass sound vibrations along to the cochlea. The result is that the person affected by the growing tumour will experience a loss of hearing, which can come on quite quickly and be severe.
What Symptoms Do Ear Tumours Cause?In addition to deafness, the growing mass of cancer cells inside the inner ear can make the pulse through the ear very audible and this is often one of the early symptoms. Others can include pain, swelling in the nearby lymph nodes in the neck, and unusual fluid production or bleeding. Tinnitus is also common, but this is a symptom that can have other causes, so by itself, it does not usually indicate cancer. The face on the side of the affected ear can be affected, as the nerves can be blocked, causing the face to look paralysed, as it might after a stroke. As ear tumours can also cause head pain, a feeling of dizziness and falling due to losing balance, the symptoms they cause can sometimes be mistaken for mild strokes.
How Are Ear Tumours Diagnosed?As the ear is a tightly enclosed space, ear tumours cannot grow very large without making their presence felt. Symptoms tend to occur early on, but it can be a problem to separate out symptoms caused by ear cancers and symptoms caused by other illnesses. Even a viral infection can produce some of the same signs. If ear cancer is strongly suspected, it is normal practice for a doctor to refer a patient to an ear, nose and throat specialist, who then arranges for a CT scan or MRI scan. This can reveal the position and size of the ear tumour and it can also show if the cancerous cells have spread to the nearby lymph nodes, or elsewhere in the body. A biopsy to find out if a mass seen on the scan is benign or malignant is then the next step.
How Are Ear Tumours Treated?The first line treatment for ear cancers that are inside the ear is surgery. This is often intricate and involved but intends to remove the cancer entirely. The surgery does carry the risk of damage to the delicate tissues of the ear, which may already be in a poor state because of the effects of the cancer, so problems after surgery can include hearing loss and problems with balance. In cases where the tumour has spread throughout the middle ear, all of the bones in the inner ear, together with the mastoid, cochlea and ear canal are removed. This gives a better chance of removing all of the cancer, but it has a much more serious impact on hearing and balance.
Follow up treatment then usually involves radiotherapy, although this is not straightforward as the radiation has to be focused very near to the brain. Chemotherapy is not generally used.
If an ear tumour is benign, it still often has to be removed by surgery, as it creates pain through pressure within the ear as it grows larger.