Partial hearing loss after head injury 2006,best noise cancelling headphones for small ears headphones,what are the signs for hearing loss quotes,t?nis nike air max leather 2013 leather tf - For Begninners

Author: admin, 07.06.2015. Category: How To Stop Ringing In Ears Home Remedies

Introduction: The cystic adenoid carcinoma (CAC) in the external auditory meatus is rare and was originated in the ceruminous glands. INTRODUCTIONThe temporal bone malignant tumors are uncommon and occur in less than 0.2% of the head and neck neoplasms (2). Case Report: In this article we report the case of a patient with Cystic Adenoid Carcinoma of the external auditory meatus with mastoid involvement that presented peripheral facial paralysis. The factors of bad prognosis are the tumor expansion, facial nerve and middle ear invasion and lymph node affection, which diminish the survival in five years from 59% to 23%.
Even with the local control of the disease, it's known to have a late metastatic presentation (6).
In the past this tumor was frequently diagnosed and treated wrongly, because it had a deceiving behavior and appearance and was mistaken for a benign disease.
It equally affects men and women (1), may appear at any age, except for children, and is proven to occur normally between the fifth and the seventh decade of life (3).The main initial symptom, in 90% of the patients, is earache (1).
Other symptoms also occur, such as bleeding, otorrhea, dizziness, deafness and facial paralysis (3). The tumor mass may present as a polyp, ulceration, granulation tissue or simply as a discreet subepithelial elevation. LITERATURE REVIEWThe adenoid cystic carcinoma was first described in 1859 by Billroth, who called it cylindroma. In 1894, Haug used for the first time the term adenoid cystic carcinoma to identify this tumor, and this denomination was restated in 1942, by Spies, Quattlebaum, Foote and Frazell.

The classification was based on aspects found in the electronic microscopy, biological activity and the answer to several modalities of instituted treatment. He denied smoking and reported occasional ethylism.A diagnosis of peripheral facial paralysis was made and the treatment was started with Prednisolone 20 mg, Acyclovir and Omeprazol. But the patient didn't obtain improvement and returned 1 month ago complaining of persistence of the peripheral facial paralysis.
We requested 40-channels mastoid multislice helicoidal computed tomography before and after the venous contrast injection, that revealed a tympanic cavity and antromastoid veiling with destruction of the epitympanum ossicles and wall, temporal bone squamous part and the external auditory meatus, with osseous fragments in the upper region of the external auditory meatus.
CT at axial cut, showing the tympanic cavity veiling and antromastoid with destruction of ossicles.Picture 2. After the surgical treatment the patient reported a partial improvement of the facial paralysis, but it culminated in hearing loss because an aggressive procedure was needed for removal of all the mass. DISCUSSIONOut of the tumors of head and neck, the squamous cells carcinoma is the most common histological type, followed by the basocellular carcinoma, adenoid cystic carcinoma, adenocarcinoma and rhabdomyosarcoma (9). Because of the extensive neural system, the head and neck malignant tumors have many ways to invade the cranial nerves and gain access to intracranial structures.
The most common tumor associated to perineural invasion was the squamous cells carcinoma, followed by the adenoid cystic carcinoma (10). Otalgia is particularly common in the adenoid cystic carcinoma cases for their tendency to invade nerves. In the above mentioned case, the main complaint of the patient was of progressive facial paralysis (4).Upon otoscopy, in general, we note a grayish or yellowish mass in the external auditory meatus, or, more rarely, medial to the integral tympanic membrane, but the normal otoscopic exam (in cases of tumor out of the meatus) may make the diagnostic suspicion very difficult.

In general, lesions localized in the outer part of the meatus are treated with a limited resection, that is, local resection, radical mastoidectomy, while more advanced lesions are treated by means of block resection, partial temporal osseous resection, subtotal petrosectomy, total petrosectomy.
In the case report, the tumor was diagnosed at a more advanced phase, partially due to the not much common symptom, peripheral facial paralysis, presented by the patient.Bibliographical References1. Carcinoma Espinocelular do Conduto Auditivo Externo: Estudo por Tomografia Computadorizada de Seis Casos.
Prognostic factors affecting the clinical outcome of adenoid cystic carcinoma of the head and neck. Management and longterm outcome of adenoid cystic carcinoma with intracranial extension: A neurosurgical perspective.
Glands carcinomas, paranasl sinus cancers and melanoma of the head and neck: an update about rare but challenging tumors.
Malignant Tumors of the Ear and Temporal Bone: A Study of 27 Patients and Review of Their Management. Coordinator of the Medical Residence Service in Otorhinolaryngology of the Hospital Sao Jose do Avai.2.

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