Malignant tumours of the ear canal
For practical purposes all of these will be squamous carcinomas, and many of them will follow prolonged discharge from an ear. Some may follow many years after radiotherapy applied to the area for another reason, including radiotherapy to the parotid gland (closely adjacent to the ear) and radiotherapy to the cranial cavity when the radiotherapy has been directed through the external ear. There is some potential for delayed diagnosis, particularly if the tumour is confused with a troublesome exacerbation of long-standing chronic otitis externa. The presentation will be with an ulcerating lesion of the ear canal, which may well expose bone at its base. One important and clinically useful feature is that there will be considerable pain associated with lesions of this kind as soon as they begin to infiltrate bone or cartilage of the ear canal.