Ear Tumors or Otic Tumors

Diagnosis

Diagnosis of ear cancer can be made through the following techniques:

• Physical examination and medical history: The patients undergo a comprehensive evaluation of the symptoms related to ear diseases. They are asked about the occurrence, duration, and progression of symptoms. In addition, the patients are inquired about the type of fluid discharged, the severity of pain, triggers of dizziness and headache, and permanent or intermittent hearing loss to detect the potential causes of symptoms. While evaluating the patients for ear cancer, the age is also considered as ear cancer most commonly occurs in people with advanced age (in the 70s). Further occupation and lifestyle are also evaluated as cancer in the outer ear (earflap) may occur due to prolonged exposure to the sun. The medical history of the patients is also examined because certain underlying medical conditions, such as recurrent ear infection increases the risk of ear cancer. The ears of the patients are thoroughly examined through an otoscope to determine the type and severity of the disease. If the patients are suspected of having ear cancer or any other serious condition, they are ordered certain imaging tests.
• Hearing tests: Hearing loss is a common symptom in patients with ear cancer. Patients who complain of poor hearing are recommended to undergo hearing tests. Sound tests are conducted to evaluate the response of the patients toward the sound at different pitches. The sound tests are pure-tone tests, acoustic reflex measures, tuning fork tests, and speech and word recognition tests. Another test, tympanometry, evaluates the movement of the eardrum. Tympanometry helps determine the presence of wax or fluid accumulation or if there is a tear or hole in the eardrum.
• Blood tests: There are no specific blood tests to diagnose ear cancer. However, the patients are advised to undergo blood tests to determine their overall health status. Blood tests are also performed before the treatment in patients with ear cancer.
• Magnetic resonance imaging: Magnetic resonance imaging uses strong magnets and radio waves to create images of the internal ear. The images assist the oncologists in determining the presence and extent of cancer in the ear. The images also provide valuable information about the spread of tumors in the lymph nodes and other organs that will help develop optimal treatment strategies. MRI also differentiates between malignant and benign tumors, such as middle ear effusions, mastoiditis, and cholesteatomas.
• CT scan: CT scan provides detailed images of the internal ear with the help of X-rays. CT is the technique of choice when the cancer is confined to the external auditory canal. CT scan also detects the local spread of the tumor by revealing the erosion of the bony auditory canal. However, in tumors that extend beyond the external auditory canal, preference is given to the contrast-enhanced MRI over the contrast-enhanced CT scan.
• PET scan: PET scan is an important imaging modality to determine the spread of ear cancer to various body parts. The technique relies on the fact that sugar is more rapidly used by cancer cells compared to healthy cells. Radioactive sugar derivative is injected into the body through the vessels. A specialized camera is used to trace the radioactive sugar. Accumulation of radioactive sugar at a particular site indicates the presence of abnormal cells, including cancer. Fortunately, most primary cancers of the external auditory canal are responsive to radioactive sugar and are useful in diagnosing small nodal metastases.
• Biopsy: Biopsy involves obtaining samples of abnormal tissues and sending them to the laboratory. In the laboratory, the pathologist examines the samples for the presence of cancer cells. The type of anesthesia depends upon the locations of abnormal tissues. Local anesthesia is sufficient if the sample is taken from the external ear. However, general anesthesia is usually used in the case of a middle ear biopsy. Biopsy, in some cases, may be assisted by imaging techniques. The biopsy is generally not performed in the internal ear, and oncologists mainly rely on imaging techniques for diagnosis.