The international expert consensus on management of external auditory canal carcinoma

Pei Zhou; Rubens de Brito; Yong Cui; Simon Lloyd; Henricus Kunst; J Walter Kutz; Navin Mani; In Seok Moon; Badr Eldin Mostafa; Cindy Nabuurs; Sampath Chandra Prasad Rao; Bingbin Xie; Yibo Zhang; Chunfu Dai

doi:10.1007/s00405-024-09033-w

The international expert consensus on management of external auditory canal carcinoma

Eur Arch Otorhinolaryngol. 2024 Oct 28. doi: 10.1007/s00405-024-09033-w. Online ahead of print.

Authors

Pei Zhou^{1

2}, Rubens de Brito³, Yong Cui⁴, Simon Lloyd⁵, Henricus Kunst^{6

7}, J Walter Kutz⁸, Navin Mani⁹, In Seok Moon¹⁰, Badr Eldin Mostafa¹¹, Cindy Nabuurs⁶, Sampath Chandra Prasad Rao¹², Bingbin Xie¹³, Yibo Zhang^{1

2}, Chunfu Dai^{14

15}

Affiliations

¹ Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
² Key Laboratory of Hearing Medicine, Eye Ear Nose and Throat Hospital, Ministry of Health, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
³ Department of Otorhinolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
⁴ Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
⁵ University Department of Otolaryngology Head and Neck Surgery, Peter Mount House, Manchester Royal Infirmary, Manchester, UK.
⁶ Department of Otorhinolaryngology, Hearing and Genes, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Otorhinolaryngology, Dutch Academic Alliance Skull Base Pathology, Maastricht University Medical Center, Maastricht, The Netherlands.
⁸ Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁹ Department of Otolaryngology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
¹⁰ Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
¹¹ Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
¹² Department of Otolaryngology, Kasturba Medical College, Manipal University, Head & Neck Surgery, Mangalore, Karnataka, India.
¹³ Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
¹⁴ Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. [email protected].
¹⁵ Key Laboratory of Hearing Medicine, Eye Ear Nose and Throat Hospital, Ministry of Health, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. [email protected].

PMID: 39466369
DOI: 10.1007/s00405-024-09033-w

Abstract

Purpose: The objective of this consensus is to provide otolaryngologists with appropriate strategies in the management of external auditory canal (EAC) carcinoma.

Methods: In the absence of randomized controlled trials, the consensus is based on expert opinions utilizing the Rand/UCLA appropriateness method [Fitch and Aguilar in The RAND/UCLA appropriateness method user's manual, RAND Corporation, Santa Monica, CA, 2001], drawing from existing literature and clinical experience.

Results: The management recommendations are structured around 12 key areas, including: definition and pathology, pathogenesis, clinical manifestations, work-up, tumor staging system, surgical management of primary tumor, surgical management of the parotid gland and the temporomandibular joint, lymph node metastasis, radiotherapy, chemotherapy, reconstruction, and follow-up.

Conclusion: Management strategies for EAC carcinoma rely on tumor extension and histopathological features. Surgical removal with free surgical margins or combination with radiotherapy, chemotherapy are most often the best options. Given the rarity of the disease, prospective, randomized, multi-institutional clinical trials should be designed to enable reliable comparisons of the outcomes of EAC carcinoma treatments, thereby providing evidence-based clinical data to establish widely accepted guidelines. It emphasizes the need for a multidisciplinary team to be involved in the management of EAC carcinoma, and regular follow-up should be implemented postoperatively.

Keywords: Clinical practice guidelines; Expert consensus; External auditory canal carcinoma; Temporal bone.

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Review

Abstract

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