Cancer of the ear is rare. Most of these cancers start in the skin of the outer ear. Between 5 and 10 out of 100 skin cancers (5 – 10%) develop on the ear.

Cancers that develop inside the ear (the middle and inner ear) are very rare.

There are 3 parts to the ear:

• the outer ear
• the middle
• the inner ear

The outer ear is the part of the ear we can see, and includes the ear canal and ear drum. It protects the rest of the ear and helps us collect sound. 

Cancer of the ear canal is quite rare, and the signs and symptoms may be subtle. They include changes in the skin, bleeding, lumps, pain, recurrent infections and loss of hearing.

The bone that surrounds the ear is called the temporal bone. The ear canal, middle ear and inner ear are all within the temporal bone. The temporal bone is part of the skull above the ear.

One part of the temporal bone is called the mastoid bone. It is the hard, smooth mound you can feel behind your ear.

The outside of the mastoid bone is a hard solid bone but inside is bone that’s shaped like honeycomb. There is air inside the small cavities. They also contain the inner ear and the nerves that control the movement of the face and tongue.

Symptoms of cancer of the outer ear

The main symptom is a spot or sore that doesn’t heal within 4 weeks.

Most squamous cell cancers are pink lumps that have a hard scaly surface. They often bleed easily and ulcerate.

You should tell you doctor about any changes to a mole, such as the mole growing, itching or bleeding.

Tests for ear cancer

Your doctor will examine you and you might have blood and hearing tests to check your general health.

The only way to confirm a diagnosis of cancer is to take a small amount of tissue (biopsy) from the abnormal area of the ear. This is then examined under a microscope. Before your doctor takes the biopsy you have a local anaesthetic to numb the area so you don’t have any pain.

You might have an MRI scan or a CT scan if the biopsy shows you have cancer. This helps your doctor decide which treatment you need.

Types

The most common type of cancer of the ear is squamous cell carcinomas. Other types of cancer affecting the outer ear include:

• basal cell cancer
• melanoma

Stages of cancer of the outer ear

The stage of a cancer tells you how big it is and how far it’s spread. It helps your doctor decide which treatment you need.

The tests and scans you have to diagnose your cancer give some information about the stage. 

Doctors use different staging systems, depending on the type of cancer.

Treatment

The main treatments for cancers that start on the outer ear are surgery and radiotherapy. Your doctor will provide the information you need to make the right decision regarding your individual condition.

Reference; Cancer Research UK ‘About Cancer of the Outer Ear’. The full text can be accessed via; https://www.cancerresearchuk.org/about-cancer/head-neck-cancer/cancer-of-the-ear/outer-about

Acoustic neuroma, also known as vestibular schwannoma, is a noncancerous and usually slow-growing tumor that develops on the main (vestibular) nerve leading from your inner ear to your brain. Branches of this nerve directly influence your balance and hearing, and pressure from an acoustic neuroma can cause hearing loss, ringing in your ear and unsteadiness.

Acoustic neuroma usually arises from the Schwann cells covering this nerve and grows slowly or not at all. Rarely, it may grow rapidly and become large enough to press against the brain and interfere with vital functions.

Symptoms

Signs and symptoms of acoustic neuroma are often subtle and may take many years to develop. They usually arise from the tumor’s effects on the hearing and balance nerves. Pressure from the tumor on adjacent nerves controlling facial muscles and sensation (facial and trigeminal nerves), nearby blood vessels, or brain structures may also cause problems.

As the tumor grows, it may be more likely to cause more noticeable or severe signs and symptoms.

Common signs and symptoms of acoustic neuroma include:

• Hearing loss, usually gradual — although in some cases sudden — and occurring on only one side or more pronounced on one side
• Ringing (tinnitus) in the affected ear
• Unsteadiness, loss of balance
• Dizziness (vertigo)
• Facial numbness and very rarely, weakness or loss of muscle movement

In rare cases, an acoustic neuroma may grow large enough to compress the brainstem and become life-threatening.

When to see your doctor

See your doctor if you notice hearing loss in one ear, ringing in your ear or trouble with your balance.

Early diagnosis of an acoustic neuroma may help keep the tumor from growing large enough to cause serious consequences, such as total hearing loss or a life-threatening buildup of fluid within your skull.

Risk factors

The only confirmed risk factor for acoustic neuroma is having a parent with the rare genetic disorder neurofibromatosis type 2. But neurofibromatosis type 2 only accounts for about 5 percent of acoustic neuroma cases.

Complications

An acoustic neuroma may cause a variety of permanent complications, including:

• Hearing loss
• Facial numbness and weakness
• Difficulties with balance
• Ringing in the ear

Acoustic neuroma is often difficult to diagnose in the early stages because signs and symptoms may be subtle and develop gradually over time. Common symptoms such as hearing loss are also associated with many other middle and inner ear problems.

Tests that aid in Diagnosis

• Hearing test (audiometry). In this test, conducted by a hearing specialist (audiologist), you hear sounds directed to one ear at a time. The audiologist presents a range of sounds of various tones and asks you to indicate each time you hear the sound. Each tone is repeated at faint levels to find out when you can barely hear.

The audiologist may also present various words to determine your hearing ability.

• Imaging. Magnetic resonance imaging (MRI) is the preferred imaging test to confirm the presence of acoustic neuroma and can detect tumors as small as 1 to 2 millimeters in diameter. If MRI is unavailable or you can’t tolerate an MRI scan, computerized tomography (CT) may be used, but it may miss very small tumors.

Treatment

Your acoustic neuroma treatment may vary, depending on the size and growth of the acoustic neuroma, your overall health, and if you’re experiencing symptoms. To treat acoustic neuroma, your doctor may suggest one or more of three potential treatment methods: monitoring, surgery or radiation therapy.

Reference; Patient Care and Health Information; Mayo Clinic – Acoustic Neuroma. Available online at https://www.mayoclinic.org/diseases-conditions/acoustic-neuroma/diagnosis-treatment/drc-20356132