Squamous cell carcinoma of the middle ear.

The clinic features of 28 cases of squamous cell carcinoma of the middle ear are reviewed. Only one patient developed cervical lymph node metastasis and one radiological evidence of pulmonary metastasis. Fourteen of 23 patients (61%) died within 5 years after treatment from intracranial extension of the neoplasm. The pathological findings in three cases in which serially sectioned temporal bones were available are described. An important feature in each case was a penetration by tumour of the bony wall on the medial wall of the middle ear to infiltrate the carotid canal and b penetration by tumour of the thin layer of bone between the posterior mastoid air cells and the dura with subsequent invasion along the dura and into the internal auditory meatus. In one case the cochlea was infiltrated from the latter situation, but direct invasion of the cochlea from the middle ear was not observed. In view of the extensive infiltration that is probably already present at the time of diagnosis, radical surgical procedures are contraindicated.