Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje Universtiy College of Medicine, Goyang, Republic of Korea.
Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2018 Aug 14;8(1):12112. doi: 10.1038/s41598-018-30536-0.
Carcinoma of the external auditory canal (EAC) is a rare tumor and little information is available regarding parotid gland in surgically treating EAC carcinomas. This study aimed to investigate the mode of parotid involvement in EAC carcinoma through staging and histopathological analysis, and to establish surgical guidelines for the parotid gland management when there is no clinical evidence of parotid involvement. Sixty-five patients with EAC carcinoma who underwent temporal bone resection and any type of parotidectomy simultaneously were retrospectively reviewed. The rate of direct parotid invasion and parotid nodal involvement was analyzed according to the stage and histopathological findings. Among the 65 patients, 39 were confirmed to have squamous cell carcinoma (SCC) and 26 were confirmed to have adenoid cystic carcinoma (ACC). Direct parotid invasion occurred in 7 of 39 patients with SCC, only in the advanced stages, and in 15 of 26 patients with ACC, regardless of stage. Metastasis to the parotid node was noted in 6 patients with advanced-stage SCC, whereas no patient with ACC showed parotid nodal metastasis. For adequate tumor control with low risk of surgical complications, evidence based tailored parotidectomy should be applied. With no evidence of parotid involvement, an elective parotidectomy can be excluded in early SCC, whereas a total parotidectomy is recommended for advanced SCC. In ACC, basal resection of the parotid gland rather than a superficial or total parotidectomy should be performed at all disease stages.
外耳道癌（EAC）是一种罕见的肿瘤，关于外科治疗 EAC 癌时腮腺的情况，相关信息较少。本研究旨在通过分期和组织病理学分析，研究 EAC 癌中腮腺受累的模式，并建立在没有临床腮腺受累证据的情况下处理腮腺的手术指南。回顾性分析了 65 例同时接受颞骨切除术和任何类型腮腺切除术的 EAC 癌患者。根据分期和组织病理学发现，分析了直接腮腺侵犯和腮腺淋巴结受累的发生率。在 65 例患者中，39 例被确诊为鳞状细胞癌（SCC），26 例被确诊为腺样囊性癌（ACC）。7 例 SCC 患者发生直接腮腺侵犯，仅在晚期发生，26 例 ACC 患者无论分期如何，均发生直接腮腺侵犯。6 例晚期 SCC 患者发生腮腺淋巴结转移，而无 ACC 患者发生腮腺淋巴结转移。为了获得足够的肿瘤控制并降低手术并发症的风险，应根据循证依据进行针对性的腮腺切除术。对于早期 SCC，没有腮腺受累的证据，可以排除选择性腮腺切除术，而对于晚期 SCC，则建议行全腮腺切除术。在 ACC 中，在所有疾病阶段，都应行腮腺的基底切除术，而不是浅腮腺切除术或全腮腺切除术。
