Primary Early-Stage Basal Cell Carcinoma of the External Auditory Canal and the Role of Sleeve Resection: Case Series and Review of the Literature.
- 1University of Parma Parma Italy unipr.it.
Abstract
Objectives
Primary basal cell carcinoma (BCC) of the external auditory canal (EAC) is an uncommon malignancy for which evidence-based treatment recommendations remain limited. This study reports two institutional cases treated with sleeve resection and provides a structured review of the published literature, with particular emphasis on patient selection, surgical technique and the limitations of the currently available evidence.Methods
A retrospective review was performed of patients with primary BCC of the EAC treated at the Otolaryngology and Otoneurosurgery Department, Parma University Hospital (Italy). In addition, a structured review of the literature based on a systematic search of PubMed and Google Scholar was conducted. Only histologically confirmed primary BCCs arising from the EAC were included. Institutional and published cases were summarised descriptively with regard to tumour stage, treatment modality, recurrence, postoperative complications, adjuvant therapy and follow-up.Results
Two patients with early-stage primary BCC of the EAC underwent sleeve resection with intraoperative frozen-section margin assessment and remained disease-free after 24 and 36 months of follow-up, respectively. One patient developed partial postoperative EAC stenosis. The literature search identified 11 additional patients from five published studies, resulting in a descriptive cohort of 13 cases. Conservative surgical approaches, including local canal resection and sleeve resection, were the most frequently reported treatments. Only one recurrence was identified across the available reports. However, treatment strategies and follow-up duration were highly heterogeneous, precluding meaningful comparisons between conservative and more extensive surgical approaches.Conclusion
Sleeve resection appears to be a feasible hearing-preserving option for carefully selected patients with early-stage primary BCC confined to the EAC and without radiological or intraoperative evidence of bony invasion. However, the currently available evidence is limited to isolated case reports and small retrospective series. Consequently, no conclusions regarding oncological equivalence with more extensive surgery can be drawn. Careful preoperative staging, intraoperative margin assessment and long-term clinical surveillance extending beyond 5 years remain essential.
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BibTeX
@article{fasanella2026primary,
title = {{Primary Early-Stage Basal Cell Carcinoma of the External Auditory Canal and the Role of Sleeve Resection: Case Series and Review of the Literature.}},
author = {Daniele Fasanella and Enrico Liaci and Maria Luce Bardon and Andrea Bacciu and Enrico Pasanisi and Filippo Di Lella},
journal = {Case reports in otolaryngology},
year = {2026},
month = oct,
doi = {10.1155/crot/9932974},
url = {https://europepmc.org/article/MED/42903695},
note = {CC BY},
}
RIS
TY - JOUR
TI - Primary Early-Stage Basal Cell Carcinoma of the External Auditory Canal and the Role of Sleeve Resection: Case Series and Review of the Literature.
AU - Daniele Fasanella
AU - Enrico Liaci
AU - Maria Luce Bardon
AU - Andrea Bacciu
AU - Enrico Pasanisi
AU - Filippo Di Lella
PY - 2026
DA - 2026/10/20
JO - Case reports in otolaryngology
DO - 10.1155/crot/9932974
UR - https://europepmc.org/article/MED/42903695
AB - Objectives Primary basal cell carcinoma (BCC) of the external auditory canal (EAC) is an uncommon malignancy for which evidence-based treatment recommendations remain limited. This study reports two institutional cases treated with sleeve resection and provides a structured review of the published literature, with particular emphasis on patient selection, surgical technique and the limitations of the currently available evidence.Methods A retrospective review was performed of patients with primary BCC of the EAC treated at the Otolaryngology and Otoneurosurgery Department, Parma University Hospital (Italy). In addition, a structured review of the literature based on a systematic search of PubMed and Google Scholar was conducted. Only histologically confirmed primary BCCs arising from the EAC were included. Institutional and published cases were summarised descriptively with regard to tumour stage, treatment modality, recurrence, postoperative complications, adjuvant therapy and follow-up.Results Two patients with early-stage primary BCC of the EAC underwent sleeve resection with intraoperative frozen-section margin assessment and remained disease-free after 24 and 36 months of follow-up, respectively. One patient developed partial postoperative EAC stenosis. The literature search identified 11 additional patients from five published studies, resulting in a descriptive cohort of 13 cases. Conservative surgical approaches, including local canal resection and sleeve resection, were the most frequently reported treatments. Only one recurrence was identified across the available reports. However, treatment strategies and follow-up duration were highly heterogeneous, precluding meaningful comparisons between conservative and more extensive surgical approaches.Conclusion Sleeve resection appears to be a feasible hearing-preserving option for carefully selected patients with early-stage primary BCC confined to the EAC and without radiological or intraoperative evidence of bony invasion. However, the currently available evidence is limited to isolated case reports and small retrospective series. Consequently, no conclusions regarding oncological equivalence with more extensive surgery can be drawn. Careful preoperative staging, intraoperative margin assessment and long-term clinical surveillance extending beyond 5 years remain essential.
SN - 2090-6765
SN - 2090-6773
ER -