According to the American Society for Microbiology, middle ear infections increased in the United States from approximately three million cases in 1975 to over nine million in 1997. Middle ear infections are now the second leading cause of office visits to physicians, and this diagnosis accounts for over 40% of all outpatient antibiotic use. Ear infections are also very common in children between the ages of six months and two years. Most children have at least one ear infection before their eighth birthday.
Following the physical examination, biopsies and imaging studies, the patient and family should meet with the skull base team — ear surgeon, head and neck surgeon, neurosurgeon, and in some cases plastic surgeon and eye surgeon. Discussions should include the possibility of facial nerve removal and grafting, if the tumor has invaded the facial nerve. In addition, most patients with extensive tumors will lose the hearing and balance functions of the inner ear. In order to isolate the tumor and remove it completely, portions of the ear canal, mastoid and inner ear will be removed in an “enbloc” operation. This means that the structures of the ear canal, drum, middle ear, and inner ear are removed in one piece. This technique reduces the possible spillage of tumor to adjacent sites, but provides a greater chance of cure.
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