Current treatment strategies for external auditory canal cancer

Auditory canal cancer is a rare form of carcinoma, making it extremely challenging to establish standard treatments through prospective studies. To date, no prospective comparative trials have been conducted, and standard treatment protocols have largely been derived from meta-analyses of case series. Several controversies remain unresolved, including the necessity of prophylactic neck dissection, the criteria for postoperative radiotherapy, and the choice between surgical treatment and chemoradiotherapy for advanced cases. These questions remain difficult to address owing to the rarity of the disease. This article aims to review the existing literature on external auditory canal squamous cell carcinoma, summarize current knowledge, and highlight areas for future research. Early-stage cancers have a favorable prognosis, with surgical treatment and postoperative radiotherapy serving as standard approaches for high-risk groups. The treatment of advanced-stage cancer remains challenging, although oncological outcomes have improved over time. Surgery combined with postoperative radiotherapy is commonly used; however, studies have shown no significant difference in prognosis compared with definitive chemoradiotherapy. Treatment strategies should be tailored to each individual case, with careful consideration of quality of life. Outcomes for inoperable cases remain extremely poor, highlighting the urgent need for new therapeutic strategies. This review summarizes the epidemiology, staging, treatment strategies, and prognostic factors of external auditory canal squamous cell carcinoma based on previous studies.