Special problems associated with cutaneous carcinoma of the ear.

Cancer of the ear is similar, in many respects, to cancer of other skin-covered parts of the body. The aggressive nature of malignancies involving the ear is often underestimated, resulting in initial undertreatment. Later, the price is paid when a much more extensive operation is required to exenterate the cancer. A more aggressive initial approach to surgical cure would often result in less morbidity and also less mortality. One should therefore be reasonably aggressive in the initial surgical management of all malignancies, including basal cell carcinoma. When cancer involves the meatus, one should be prepared to perform a lateral temporal bone resection to ensure complete tumor extirpation. The available reconstructive options, including hearing rehabilitation, allow aggressive treatment to be tolerated reasonably well by most patients. Aggressive surgical resections of the external ear can be reconstructed, with very reasonable cosmetic and functional results. With sufficiently aggressive treatment, the chances for successful tumor control can be generally very good.