#INTERNAL AUDITORY CANAL CT ANATOMY UPDATE#
These guidelines should enable uniform multi-institutional data collection and thus assist with development of a staging system for EAC and temporal bone lesions.Ī brief summary of the regional anatomy, etiology and epidemiology, presentation and diagnosis, radiologic assessment and treatment follows with a review of the pathologic assessment of the different types of specimens generated and an update on the current staging proposals. The International Consortium on Cancer Reporting (ICCR) has recently developed comprehensive pathology reporting guidelines for these specimens, due for publication in 2018. Furthermore, an internationally accepted staging system entrenched in a strong evidence base is not available. Until recently, guidelines for macroscopic and microscopic examination of these specimens were lacking. This information is of prognostic significance and thus clear communication between the surgical and diagnostic teams is essential to obtain optimum orientation and anatomical landmarks. The histologic diagnosis of the more common entities such as SCC, BCC and adenoid cystic carcinoma is straightforward however, the precise identification of the epicentre of the tumor and its extent can be extremely challenging in an unoriented or otherwise compromised specimen. This is further compounded by the rarity of these specimens as well as the use of terminology that pathologists encounter infrequently. The surgical treatment of this anatomically complex region generates complicated three-dimensional specimens that can be challenging to handle at the macroscopic examination.
Surgery with or without post operative radiotherapy form the mainstay of treatment for these neoplasms. While primary neoplasms of the EAC and the temporal bone are uncommon, these structures are more frequently involved by cutaneous squamous cell carcinomas (cSCC) of the pinna, or metastatic cSCC involving the parotid or post auricular lymph nodes, particularly in countries with a fair skinned population and high ultraviolet index. Squamous cell carcinoma (SCC) is the most common neoplasm of these sites, followed by basal cell carcinoma (BCC), adenoid cystic carcinoma (ACC), ceruminous adenocarcinoma and middle ear adenocarcinoma. Malignant neoplasms of the external auditory canal (EAC), the middle and inner ear are rare.
0 kommentar(er)
