1. Cancer of middle ear Chunfu Dai M.D & Ph.D

2. Background Primary tumor in middle cavity Primary tumor in middle cavity Predilection in 40-60 y Predilection in 40-60 y Dominated by squamous carcinoma Dominated by squamous carcinoma Associated with chronic otitis media Associated with chronic otitis media

3. Clinical presentations Ear discharge with blood Ear discharge with blood Otalgia and headache Otalgia and headache Hearing loss Hearing loss Facial paralysis Facial paralysis Dysplagia Dysplagia Involvement of other cranial nerves Involvement of other cranial nerves Metastasis to associated lymphatic node Metastasis to associated lymphatic node

4. Diagnosis Clinical demonstrations Clinical demonstrations Physical examination Physical examination Neoplasm in middle ear Neoplasm in middle ear Hemorrhage Hemorrhage CT, MRI: to determine the extension of mass CT, MRI: to determine the extension of mass Biopsy: to make histological diagnosis Biopsy: to make histological diagnosis Genernal examination: to exclude remote metastasis Genernal examination: to exclude remote metastasis

5. Intervention Comprehensive therapy Comprehensive therapy Radiotherapy+surgery+chemotherapy Radiotherapy+surgery+chemotherapy Surgery Surgery Partial temporal bone resection Partial temporal bone resection Subtotal temporal bone resection Subtotal temporal bone resection Temporal bone resection Temporal bone resection Basilar carcinoma: surgery, no extra radiotherapy Basilar carcinoma: surgery, no extra radiotherapy Rabraddmone carcinoma: chemotherapy+radiotherapy+surgery Rabraddmone carcinoma: chemotherapy+radiotherapy+surgery