Management of External Auditory Canal Squamous Cell Carcinoma in a Tertiary Care Center

Background: Squamous cell carcinoma (SCC) of external auditory canal (EAC) is rare malignancies. They are dealt with a combination of surgery in case they are operable and postoperative treatment with radiotherapy (RT) with/without chemotherapy based on the extent of involvement. The complexity of the anatomy that is dealt with here makes the diagnosis and treatment difficult. Materials and Methods: Four patients of SCC of EAC were reviewed retrospectively between 2019 and 2023. Results: All patients were aged between 50 and 70 years, all patients presented with otalgia, aural fullness, and bloody/blood‑stained discharged. One patient presented with preoperative facial nerve palsy; One patient had a history of undergoing surgery for a squamous variety of chronic otitis media; one patient presented with involvement of the pinna along with EAC. Three patients were treated with lateral temporal bone resection and superficial parotidectomy with neck dissection followed by postoperative RT and one patient was sent for palliative RT in view of the skull base and intracranial involvement. Conclusion: A holistic approach is required for SCC of EAC considering it usually mimics other common otological conditions with presentation such as otalgia, blood‑stained discharge; preoperative radiology is imperative in deciding the extent of resection. Their lack definitive anatomical landmarks for its progression and hence EAC SCC are aggressive tumors prone for perineural and lymphovascular invasion along with high rates of recurrence.