Hearing and balance complaints as presenting symptoms of petrous bone malignancies

Abstract

Objective: Hearing loss and imbalance are specific symptoms of inner ear disease which could hide severe condition, such as endolymphatic sac tumour (ELST) or squamous cell carcinoma (SCC). The audiologist or the otologist, starting from not specific audiologic and vestibular symptoms can be faced by malignant tumours with severe prognosis, where early diagnosis can make the difference in outcome of treatment.

Methods: We assessed the presenting symptoms, the audiological pattern, therapy and outcomes in 17 cases of ear malignancies (seven patients affected by ELST and ten by SCC).

Results: All of ELST cases reported hearing loss as presenting symptom. Dizziness and imbalance were present in most cases. The mean diagnostic delay from the clinical onset was 26 months. Most patients were treated with extensive lateral skull base procedures. The recurrence rate and disease free-survival were 20% and 80%, respectively. In SCC patients, ear pain was the most frequent symptom, followed by dizziness and fullness. In all cases, treatment involved surgery with large extensive procedures. The recurrence and disease free-survival were 50% and 50%, respectively.

Conclusion: Ear malignancies are difficult to detect, a specific audiological and vestibular symptoms should not be underestimated, early diagnosis and therapy influence the unfavourable outcome.

Keywords:

• Petrous bone cancer
• hearing loss
• balance impairment
• ear tumours

Disclosure statement

No potential conflict of interest was reported by the author(s).