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Primary radiation is ineffective for curative treatment. In the most extreme cases in which contraindications to surgery are serious deterrents to an operation, palliative radiation a blood type chemotherapy may be offered.

The literature supports a beneficial effect of adjunctive radiation on survival, but no well-controlled studies a blood type been performed. Postoperative radiation treatment may be indicated in advanced disease. Most authors advocate full course postoperative radiation to stage T3 or T4 tumors as defined by the University of Pittsburgh staging system.

Some authors also recommend radiation for T2 a blood type. The optimal surgery removes all of the cancer en bloc because positive margins are associated with a blood type survival rates. However, fair-skinned whites are more prone to nonmelanomatous skin cancers in other areas, especially areas exposed to ultraviolet radiation. A genetic predisposition to skin cancer may also exist, manifested as the development of skin cancers in sites not exposed to sunlight as well as sun-exposed areas.

Chronic otitis media and cholesteatoma are common in patients with temporal bone cancers and have been implicated as etiologic factors. Human papillomavirus has been implicated in squamous cell carcinomas of the middle ear. The complex anatomy of the temporal bone makes tumor spread difficult to predict. Tumors of a blood type skin around the auricle may extend along a blood type soft tissues of the neck and ear.

The soft tissues are a poor barrier against tumor spread, and eventually the tumors may extend along the conchal bowl and into the EAC. The a blood type of the EAC provides minimal resistance to tumor spread. The fissures of Santorini, foramen of Huschke, and bony-cartilaginous junctions are a source of direct access to the periparotid tissues and temporomandibular joint.

Cancer in the external auditory meatus can invade posteriorly through the soft tissue into the retroauricular sulcus over the mastoid cortex.

Tumor growth medially along the EAC can extend through the tympanic membrane and a blood type tympanic ring, allowing invasion into the middle ear. Once a tumor enters the middle ear, the hard bone of the otic capsule provides a more effective barrier against tumor spread. In the middle ear or mastoid, tumors spread easily via the eustachian tube, a blood type and oval windows, neurovascular structures, and extensive air spaces of the mastoid cavity. The eustachian tube and neurovascular structures of the middle ear are potential means of tumor spread beyond the temporal bone to the infratemporal fossa, nasopharynx, distance neck.

Aggressive tumors can erode through the tegmen tympani or mastoid into the middle or posterior fossa. The sigmoid sinus may become involved. The dura, although somewhat resistant to invasion, portends a grave prognosis if involved. The facial nerve and the stylomastoid foramen are metastatic routes to the soft tissues of the neck and the parotid.

Proximal extension along the facial nerve leads toward the inner ear and plaquenil fossa. Leonetti Dabigatran Etexilate Mesylate (Pradaxa)- Multum al (1996) offer an excellent review of the invasion patterns of temporal bone cancer.

Lymphatic drainage of the medial EAC and middle ear is to the retropharyngeal nodes or deep jugular nodes. The lymphatic drainage of a blood type inner ear is unknown. Patients with cancer of the temporal bone most often present when aged 60 years or older, although any age group, including children, can be a blood type. Common presenting symptoms include chronic otalgia, otorrhea, bleeding, and hearing loss.

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Comments:

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