Abstract
Malignancies of the auricular skin tend to metastasise to preauricular, parotid, facial,
and level II (possibly to levels IV and V) lymph nodes in an unpredictable manner.
Over the years, we have observed that this pattern of metastasis is commonly linked
to lesions that involve the lower half of the ear. To find conclusive evidence based
on this hypothetical observation, we retrospectively studied 108 patients who presented
with squamous cell carcinoma (SCC) of the ear, and looked at the exact auricular site
of the lesion at presentation, incidence of metastasis, nodal involvement, treatment,
and survival outcome. The literature was reviewed extensively to ensure detailed presentation
of the lymphatic drainage pathway. The pattern of spread and outcome were evaluated.
This study has shown that there is a significant correlation between anatomical position
and risk of metastasis, and that lesions of the lower half of the ear are more prone
to metastasis. These patients therefore may warrant early imaging, possible sentinel
node biopsy, or even selective neck dissection with simultaneous primary excision.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A retrospective analysis of histological prognostic factors for the development of lymph node metastases from auricular squamous cell carcinoma.Histopathology. 2010; 57: 138-146
- Cancer of the ear: a report of 150 cases.Laryngoscope. 1960; 70: 551-579
- Guidelines for prophylactic radical lymph node dissection in cases of carcinoma of the external ear.Head Neck Surg. 1980; 2: 361-365
- Squamous carcinoma of the external ear.Am J Surg. 1983; 146: 447-450
- Squamous cell carcinoma of the pinna.Br J Plast Surg. 1983; 36: 171-175
- Cutaneous squamous-cell carcinoma.N Engl J Med. 2001; 344: 975-983
- Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection.J Am Acad Dermatol. 1992; 26: 976-990
- Cutaneous head and neck SCCs and risk of nodal metastasis-UK experience.J Craniomaxillofac Surg. 2009; 37: 443-447
- Epidemiology of basal cell carcinoma and squamous cell carcinoma of the pinna.J Laryngol Otol. 2001; 115: 85-86
- Lymph node metastases from auricular squamous cell carcinoma. A systematic review and meta-analysis.J Plast Reconstr Aesthet Surg. 2008; 61: 1140-1147
- Melanoma of the ear: treatment and survival probabilities based on 199 patients.Ann Plast Surg. 2006; 57: 70-76
- Lymphatic drainage of the external ear.Head Neck. 2011; 33: 60-64
- Location of sentinel lymph nodes in patients with cutaneous melanoma: new insights into lymphatic anatomy.J Am Coll Surg. 1999; 189: 195-204
- Squamous cell carcinoma of the pinna: which histological features could be used to predict prognosis?.Br J Oral Maxillofac Surg. 2017; 55: 524-529
- Epidemiology of basal cell carcinoma: a 10-year comparative study.Br J Oral Maxillofac Surg. 2018; 56: 101-106
- Malignant tumours of the ear and their treatment. I. Tumours of the auricle.Br J Plast Surg. 1974; 27: 67-76
Article info
Publication history
Published online: May 14, 2020
Accepted:
April 21,
2020
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.
