Nibu K, Kamata S, Kawabata K, Takahashi H, Nakamizo M, Shimada S, Hoki K, Yagi K, Uchida M
Department of Head and Neck Surgery, Cancer Institute Hospital, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 1992 Sep;95(9):1379-88. doi: 10.3950/jibiinkoka.95.1379.
In the past 20 years from 1970 to 1990, 21 patients with malignancies of the ear were treated at Cancer Institute Hospital. The primary sites were the auricle and cartilaginous external auditory canal (group 1: n = 8), the bony external auditory canal (group 2: n = 6) and the middle ear (group 3:n = 7). In group 1, pathological types were squamous cell carcinoma in four patients and basal cell carcinoma in the other four patients. Seven patients were treated by surgery alone, and the remaining patient was treated by interstitial implant radiotherapy. No recurrence have been noted up to today in this group. In group 2, pathological types were squamous cell carcinoma in four patients and adenoid cystic carcinoma in the other two patients. All of the six patients underwent external canal resection or subtotal temporal resection. Two patients received postoperative radiotherapy. A five year survival rate of group 2 was 60%. In group 3, pathological types were squamous cell carcinoma in six patients and undifferentiated carcinoma in the remaining patient. Most of them underwent radical mastoidectomy followed by irradiation. However, all the patients died within two years after treatment. In group 2 and 3, cytodiagnosis was useful for early discovery. In group 2, temporomandibular joint seemed to be a key point in surgical treatment. In group 3, the combination of conservative surgery with radiotherapy was not a radical treatment. This suggested it necessary to perform subtotal temporal resection to treat malignancy of the middle ear.
在1970年至1990年的过去20年里,癌症研究所医院共治疗了21例耳部恶性肿瘤患者。原发部位分别为耳廓和软骨性外耳道(第1组:n = 8)、骨性外耳道(第2组:n = 6)和中耳(第3组:n = 7)。第1组中,4例为鳞状细胞癌,另外4例为基底细胞癌。7例患者仅接受了手术治疗,其余1例患者接受了组织间植入放疗。该组至今未发现复发情况。第2组中,4例为鳞状细胞癌,另外2例为腺样囊性癌。6例患者均接受了外耳道切除术或颞骨次全切除术。2例患者接受了术后放疗。第2组的5年生存率为60%。第3组中,6例为鳞状细胞癌,其余1例为未分化癌。大多数患者接受了根治性乳突切除术并辅以放疗。然而,所有患者均在治疗后两年内死亡。在第2组和第3组中,细胞诊断有助于早期发现。在第2组中,颞下颌关节似乎是手术治疗的关键。在第3组中,保守手术与放疗相结合并非根治性治疗方法。这表明有必要进行颞骨次全切除术来治疗中耳恶性肿瘤。