Benign Tumors of The Ear Canal

Benign tumors can develop anywhere in the ear canal. Common benign tumors include keloids, osteomas, and sebaceous cysts. Blacks and young women are most susceptible to keloids, which tend to recur. Osteomas are three times more common in males than in females.

These tumors seldom become malignant; with proper treatment, the prognosis is excellent.

Causes

Sebaceous cysts are the most common cysts seen in the ear. They are bulging, sac-like collections of dead skin cells and oils produced by oil glands in the skin.

They commonly occur behind the ear, within the ear canal, or on the scalp. The exact cause is unknown, but cysts may occur when oils are produced in a skin gland faster than they can be excreted out of the gland. If the cysts within the ear canal get infected, they are extremely painful.

Signs and Symptoms

The patient usually doesn't report any symptoms unless the tumor becomes infected, in which case he may complain of pain and fever or inflammation. A patient history of pain is commonly a symptom of a malignant tumor.

Assessment Tip Malignant tumors may be found in the external ear. The most common cutaneous carcinomas are basal cell carcinomas on the pinna and squamous cell carcinomas on the ear canal. If left untreated, the carcinoma can invade the underlying tissue.

On otoscopic examination, a keloid appears as elevated tissue that is round and firm, with irregular margins.

Osteomas usually occur bilaterally and in multiples (exostoses) and appear as bony outgrowths from the wall of the external auditory meatus.

A sebaceous cyst usually is palpated behind the ear near the lobule or meatus within the skin and appears as a small cyst with a black dot in the center. The cheeselike contents of the cyst have a rancid odor.

Diagnostic tests

When otoscopic examination confirms a tumor, biopsy is used to rule out cancer.

Treatment

A benign tumor usually requires surgical excision if it obstructs the ear canal, is cosmetically undesirable, or becomes malignant.

Treatment for a patient with a keloid may include surgery, followed by repeated injections of long-acting steroids into the suture line. Excision must be complete, but even this may not prevent recurrence.

Surgical excision of an osteoma consists of elevating the skin from the surface of the bony growth and shaving the osteoma with a mechanical burr or drill.

Before surgery, a patient with a sebaceous cyst requires preliminary treatment with antibiotics to reduce inflammation. To prevent recurrence, excision must be complete, including the sac or capsule of the cyst.

Prevention

If the cause is genetic, there is no way to prevent benign ear cysts. Those who have problems with ear drainage tubes may need surgery to improve or bypass the tube. Surgery to remove an overgrowth of tissue in the upper part of the throat may help in some cases.

Treating allergies, ear infections, and chronic sinus infections may also help prevent cysts. An ear tube, or artificial tube to equalize pressure, may need to be inserted into the ear.