What are the symptoms of ear tumors

The ear is a very important part of the human body structure. People listen to and classify the sounds in daily life through the ear, which plays a very important role in people's daily life. However, a fragile part like the ear is prone to problems, and a more serious one is an ear tumor. When an ear tumor occurs, it is very serious and has a great impact on people's daily life. So what are the specific symptoms of ear tumors in daily life?

Symptoms of ear tumors

Clinical manifestations:

(I) Facial nerve and acoustic nerve neurotheca tumor

Otic neurothecomas mostly arise from the vestibular and cochlear branches of the auditory nerve and account for about 8% of intracranial tumors. A small number of neurothecomas arise from the facial nerve. If the location of the neurotheca is in the internal auditory canal or cerebellopontine angle, the clinical manifestations are quite similar.

The main symptom of internal auditory canal and cerebellopontine angle neurothecoma is ipsilateral deafness. Most patients gradually lose their hearing without realizing it, and about 15% of patients have sudden deafness. The second main symptom of this disease is ipsilateral tinnitus, and vertigo is rarely reported. In the later stages, trigeminal nerve palsy and facial nerve paralysis may occur. Facial nerve schwannomas can arise anywhere within the temporal bone. When the tumor occurs in the middle ear or mastoid segment of the facial nerve, the first symptom is conductive hearing loss. Facial nerve paralysis starts slowly and gradually becomes more severe. Sometimes the tumor is very large and the facial paralysis is only partial. Some patients with facial nerve schwannoma have facial paralysis that occurs suddenly and resembles Bell's palsy. The maximum degeneration of the facial nerve shown by evoked electromyography was observed at . Bell's palsy develops within 2 weeks of onset, whereas space-occupying lesions usually occur after 2 weeks. Multiple episodes of facial paralysis are also a suspicious sign of facial nerve schwannoma.

(ii) Petrous apex cholesteatoma

Since the advent of CT and MRI, petrous apex cholesteatoma, which was previously thought to be rare, can now be diagnosed, and its incidence is not as low as imagined.

When petrous apex cholesteatoma is still confined to the petrous bone, there may be no clinical symptoms. It is usually detected only when it invades the facial nerve, causing nerve ischemia and compression, resulting in facial paralysis. Petrous apex cholesteatoma can destroy the labyrinth leading to the mastoid process of the middle ear. At this time, a white mass may appear behind the tympanic membrane without any signs of tympanic membrane perforation or middle ear infection.

CT and MRI examinations are essential diagnostic steps to estimate the location, extent, and adjacent important structures of cholesteatoma.

(III) Tympanic cavity and glomus jugularis tumors (paraganglioma)

Systemic paragangliomas arise from extra-adrenal paraganglia (chromaffin bodies). Paraganglia are derived from neural crest cells and can store and secrete catecholamines. This discharge often causes symptoms and can be used to diagnose tumors. In the head and neck region, paragangliomas are associated with structures of the ontogenous branchial arches, which have been named chromaffin bodies. The primary sites of head and neck body tumors are the carotid bodies, tympanic bodies of the middle ear, jugular bodies of the jugular bulb, and vagal bodies of the vagus nerve.

Applying pressure with an air-filled otoscope can cause the retrotympanic tumor to turn white and pulsate more vigorously, a phenomenon known as Brown's sign. Over time, the tumor may penetrate the eardrum and grow into the ear canal, resembling a brittle polyp.

Vagal paraganglioma arises from the paraganglionic cells of the vagal nerve membrane, mostly located in the nodose ganglion. This tumor resembles the tympanic body tumor and the jugular glomus tumor. The symptoms are quite insidious. It is a painless, slowly enlarging tumor. Hoarseness caused by vagus nerve paralysis may be the patient's earliest complaint, and neck or throat pain only occurs when the tumor affects the pharyngeal plexus. Tumors that grow into the middle ear can cause pulsatile tinnitus, hearing loss, and vertigo.

Body tumors have the ability to secrete catecholamines, but generally the amount secreted is not enough to cause symptoms. Pheochromocytoma of the craniocervical region can secrete norepinephrine as the primary catecholamine, causing headache, sweating, palpitations, pallor, nausea, and hypertension.

As a screening test, 24-hour urinary 3-O-methylepinephrine and catecholamine metabolites (VMA) can be measured. For those with positive test results, venous blood was taken to measure norepinephrine and dopamine. Other tests include serum catecholamines, glucose, and insulin. If serum adrenaline is elevated, attention should be paid to identifying the concurrent pheochromocytoma.

Biopsy is not necessary in this disease and carries the risk of causing excessive bleeding. CT can accurately determine the location of the tumor and the involvement of the surrounding bones and soft tissues. Dynamic CT can help understand the degree of tumor blood supply. MRI can show the boundaries of the tumor, especially its relationship to the brain, and can also distinguish between inflammation and hematoma. Arteriography can show the blood supply arteries of the tumor, reflect the relationship between the tumor and large blood vessels, and be used for tumor artery embolization.

4. Temporal bone malignant tumor

Malignant tumors of the temporal bone often originate from the external and middle ear. 60% originate from the auricle, 28% first appear in the external auditory canal, and only 12% occur in the middle ear. The average age of the patients was 55 years. Squamous cell carcinoma is the most common malignant tumor of the temporal bone, followed by basal cell carcinoma, adenocarcinoma, malignant melanoma and sarcoma.

Clinical manifestations vary according to location. Cancer of the external auditory canal may cause ear pain, chronic otorrhea, and bleeding. It is worth noting that there is often a history of chronic inflammation before cancer, and sometimes difficult-to-heal ulcers and local granulation proliferation may occur in the ear canal. Cancerous tissue may gradually block the ear canal, and only a biopsy can provide a definitive diagnosis. Hearing loss is conductive in the early stages and sensorineural in the later stages when the inner ear is invaded.