A temporal bone tumor can be benign or cancerous. This type of tumor is rare and forms when cancer of the skin invades the outer part of the ear and the ear canal. In most cases, the temporal bone tumor is a squamous cell carcinoma, adenoid cystic carcinoma or ceruminomatous adenoid carcinoma of the ear. Other cancers that develop in the bones of the ear are usually caused by an invasion from nearby internal structures such as the parotid salivary glands, which are located in front of the ear canals. Although benign temporal bone tumors can cause hearing loss, they also result in pulsating sounds that only the patient hears.
Causes of Temporal Bone Tumors
The exact cause of most temporal bone tumors is unknown. Past patient studies have linked the tumors to sun exposure to the outer ear and skin irritations from ear drainage and infections. Genetic abnormalities may also play a role in these cancers.
Treatments for Temporal Bone Tumors
A benign tumor can often be removed from the ear through surgery. Before a surgery is performed, a doctor performs a computed tomography (CT) or magnetic resonance imaging (MRI) scan. After reviewing the images and biopsy specimens, the surgery method will be selected.
A small tumor can often be removed through the ear canal. If the tumor is large, an incision behind the ear allows the doctor to access it. In some cases, radiation therapy is needed. A type of surgery called sleeve resection is an option if the tumor is located in the third of the ear canal closest to the ear’s opening. If the tumor is in the inner two-thirds of the ear canal or in the bony parts of the canal, a lateral temporal bone resection may be needed. This involves removing the ear canal, ear drum, and two of the ear bones. In some cases, the parotid gland, jaw joint and lymph nodes need to be removed.
Reconstructive surgery may need to be performed after the cancer is gone. If a tumor is located in the area behind the ear drum, a sub-total temporal bone section is needed. This surgery blends the lateral temporal bone resection with removal of other inner ear structures. When a tumor is located in the inner ear, the prognosis is not as high and more complications may result, such as total hearing loss.
Treatment Plans for Temporal Bone Tumors
Because operations for temporal bone tumors are complex and the cancer is rare, most medical centers only perform a few such surgeries in a calendar year. Successful treatment of these tumors requires the participation of an experienced medical team consisting of radiologists, reconstructive surgeons, oncologists, head and neck cancer specialists, neurotologists, and pathologists. These professionals work together to inform patients of treatment options and work to help patients become informed participants in the treatment plan. Each cancer patient receives a customized plan of care for the most efficient temporal bone tumor surgery for them and recovery after the surgery.