ENT: Tumors of external ear

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Tumors of external ear 
 Benign lesions of external ear
1. Chondrodermatitis nodularis chronica helicis (CNCH):

Etiology
*    unknown
*    may begins with some minor trauma to the ear that causes chronic inflammation of the perichondrium, resulting in local vascular compromise. This vascular disruption then creates the observed clinical sequelae of painful nodules.

Treatment
 Surgical excision - surgical options include curettage, electrocautery, carbon dioxide laser ablation, and excision of skin and cartilage with closure
Medical options - radiation therapy, cryotherapy and topical antibiotics.

2. Idiopathic cystic chondromalacia:

Lesions of ICC present as unilateral asymptomatic swelling on the auricle and appear in the scaphoid fossa in 80% of patients. The lesions contain viscous yellow fluid. Usually no ulceration present.

Treatment
·        Intralesional steroids
·        Simple aspiration of the cyst fluid
·        Complete excision of the cyst
·        Excising the anterior cyst wall followed by sclerosing the posterior cyst wall with 1%  iodine solution.
Premalignant lesions of external ear
1. Actinic keratosis (AK):

·        Cause:sun exposure
·        AK presents as round or irregularly shaped lesions that are scaly, keratotic, and flat  topped.
·        The color varies from gray to deep brown.  
·        Dysplastic cells can be present.
     
Benign tumors of external ear
1.   Osteoma-

The masses are solitary, unilateral, and slow growing.
These are the most common bony neoplasms of the temporal bone.
Osteomas are usually asymptomatic; however, symptoms can arise if canal obstruction occurs.
2.   Squamous papilloma:
Squamous papilloma may be a result of exposure to the human papillomavirus. The lesion presents as a warty, elevated lesion that may be pigmented.
3.   Seborrheic keratosis:
It presents as an oval rough plaque. Early, the lesion appears light yellow. Moreover, it becomes browner as its size increases.
4.   Sebaceous adenoma:
These tumours arise from sebaceous glands located in the skin of the ear and EAC; they present as a smooth, Elevated, Pedunculated, firm to-soft lesion.
The lesions usually are solitary and smaller than 0.5 cm.
SA lesions can bleed from trauma. But they rarely ulcerate.
5.   Pilomatrixoma:
The lesion presents as a slow- growing, bluish, solitary, and well-circumscribed nodule within the dermis of the auricle.
6.   Keratoacanthoma:
Keratoacanthoma has been linked to sun exposure, chemical carcinogens, trauma, and possibly a viral etiology. Keratoacanthoma arises from the hair follicles.
7.   Ceruminoma:
The lesion is a result of neoplasia of the ceruminous glands of the EAC

WHO classification:
·        Benign: ceruminous adenoma and pleomorphic adenoma.
·        Malignant: adenoid cystic carcinoma and adenocarcinoma


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notes.nursium.com: ENT: Tumors of external ear
ENT: Tumors of external ear
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