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CION Cancer Clinics
Temporal bone resection for cancer of the ear canal | CION Cancer Clinics
Temporal bone resection is an operation to remove cancer of the ear canal, or cancer that has grown into the bone around the ear. The temporal bone is the hard bone at the side of the skull that holds the ear canal, the hearing organ and the facial nerve. How much is removed depends on how far the cancer has spread, and that decides what happens to hearing and facial movement. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a temporal bone resection?
- How much bone is removed?
- What is the path from diagnosis to recovery?
- Which words will you see in the notes?
- What can change in everyday life afterwards?
- What do families often believe about ear canal cancer?
- Who is this operation not suitable for?
- Common questions about temporal bone resection
The short answer
What is a temporal bone resection?
It is the removal of part or all of the temporal bone, the hard bone around the ear, to take out a cancer growing in or through it. Most often the cancer started in the skin lining the ear canal and has grown into the bone.
Why the bone has to come out too
The ear canal runs through solid bone. A cancer there cannot be cut out with a thin rim of skin, because it spreads along and into the bone. To get a clear margin, meaning healthy tissue all round the removed cancer, the surgeon takes the canal out together with its bony wall, in one piece where possible.
How these cancers usually show up
Ear canal cancer is rare, and it is often mistaken for a long-standing ear infection. Discharge that keeps coming back, bleeding from the ear, ear pain that wakes you at night, a lump in the canal or weakness of one side of the face are the usual signs.
A biopsy, a small sample of tissue checked under a microscope, is the only way to confirm cancer. Ear drops that seem to help do not rule it out.The three extents
How much bone is removed?
Surgeons describe three main extents. Your scans and the biopsy decide which one is planned.
Lateral (sleeve) resection
Removes the ear canal, the eardrum and the tiny hearing bones behind it, leaving the inner ear in place. Used when the cancer is confined to the canal.
Usually means
- Much less hearing on that side
- The facial nerve is often kept
Subtotal resection
Goes deeper, taking the middle ear and inner ear with the canal. Used when the cancer has reached the middle ear.
Usually means
- Complete loss of hearing on that side
- Dizziness while the other ear takes over
- Greater risk to the facial nerve
Total resection
Removes almost the whole temporal bone, often with a neurosurgeon. Used for cancer that has spread widely through the bone. It is a very large operation and does not suit everyone.
What else may be done
The parotid gland in front of the ear, and lymph nodes, the small glands in the neck that filter fluid, are often removed at the same time. The space left behind is usually filled with tissue moved from elsewhere in the body.
Not sure whether this applies to you?
Ask an oncologistThe pathway
What is the path from diagnosis to recovery?
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Biopsy and scans
A sample is taken from the canal. A CT scan shows the bone and an MRI shows soft tissue and nerves. Together they show how far the cancer has spread.
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Hearing and face checks
Both ears have a hearing test before surgery. It matters most for the ear that is not being operated on, because you will rely on it afterwards. How well your face moves is recorded too.
-
Tumour board
Head and neck surgeons, radiation oncologists and radiologists review the case together and agree the extent of surgery and whether radiotherapy should follow.
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The operation
Done under general anaesthetic, through a cut behind the ear that may extend into the neck. The opening of the ear canal is usually closed over with skin.
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Recovery on the ward
You wake with a head dressing and possibly a drain in the neck. If the inner ear was removed, dizziness and unsteadiness are common at first. Nurses and physiotherapists help you walk safely.
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Radiotherapy afterwards
Many people have radiotherapy once the wound has healed, especially if the cancer was large or close to the edge of what was removed.
On your report
Which words will you see in the notes?
- Temporal bone
- The bone at the side and base of the skull that holds the ear canal, the hearing organ and the balance organ.
- Squamous cell carcinoma
- The most common type of ear canal cancer. It starts in the thin, flat skin cells lining the canal.
- Facial nerve
- The nerve that moves the muscles of your face on that side. It runs through the temporal bone.
- Parotidectomy
- Removal of the parotid gland, the saliva gland just in front of the ear.
- Free flap
- Skin, fat or muscle moved from another part of the body, with its blood vessels joined up again, to fill the space.
- Staging
- A description of how far the cancer has spread.
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Living with the changes
What can change in everyday life afterwards?
What may change
What usually helps
Hearing loss on the operated side
Protecting the other ear; for some, a bone-conduction hearing device later
Dizziness after the inner ear is removed
Balance exercises while the brain adapts over weeks to months
Weakness of the face if the nerve is affected
Eye protection first, then nerve repair or facial physiotherapy
A closed ear opening and a change in shape
Reconstruction, and for some an artificial ear fitted later
Numbness around the ear and scalp
Often improves slowly; tell the team if it becomes painful
Commonly believed
What do families often believe about ear canal cancer?
"It is just an old ear infection, so more drops will clear it."
Long-standing discharge is usually infection. But an ear that bleeds, hurts badly at night or keeps discharging despite treatment needs an ENT examination and, where anything looks unusual, a biopsy. Delay lets a cancer grow into the bone, which makes the operation larger.
"Removing the ear bone will leave the face paralysed."
Not always. In a lateral resection the facial nerve is usually kept. The nerve is at higher risk when the cancer has grown close to it.
"Losing hearing in one ear means being deaf."
Most people keep their hearing in the other ear and manage conversation well, especially face to face. Noisy rooms and telling where a sound is coming from become harder.
"Once it has reached the bone, there is no point operating."
Spread into the bone is exactly what this operation is designed for. Whether it is suitable depends on how far the cancer has spread, your general health and what you want from treatment, which your team weighs with you.
Being straight with you
Who is this operation not suitable for?
It is not suitable when the cancer has spread widely into the brain, around the main blood vessels in the neck or to distant organs, because removing it all would not be possible. It may also not suit people whose heart or lung health would make a long anaesthetic too risky.
What the team weighs
They look at how far the cancer has spread on the scans, the type of cancer, your general health, the hearing in your other ear and your own priorities. For some people, radiotherapy with or without chemotherapy is the main treatment instead. That decision belongs to you and your treating team together.
What this page cannot tell you
It cannot tell you which extent of surgery you need, whether your facial nerve can be kept, or what your outlook is. Those depend on your own scans and the laboratory report on the removed tissue.
Questions we are asked
Common questions about temporal bone resection
How long does the operation take?
It is a long operation, often taking most of a day when neck surgery and reconstruction are done at the same time. A smaller lateral resection takes less time. Your surgeon will give you an estimate so that your family knows what to expect while they wait outside theatre.
Will I hear from that ear again?
After a lateral resection the inner ear is kept, so some people can use a bone-conduction device that passes sound through the skull. After a subtotal or total resection the hearing organ is removed, and hearing on that side does not return. Ask for a hearing assessment before and after surgery.
Will my face look different?
The ear opening is usually closed, and the area behind the ear may look fuller or flatter depending on the tissue used to fill the space. If the facial nerve is affected, one side of the face may droop. Your surgeon can describe what is likely for you and what can be done later.
Why do I need a neck operation too?
Ear canal cancer can spread to the lymph nodes in the neck and to the parotid gland in front of the ear. Removing them helps the laboratory stage the cancer properly and takes out disease that may not show on scans. Whether it is needed depends on the size and spread of the cancer.
Will I feel dizzy after surgery?
If the inner ear is removed, strong dizziness and unsteadiness are common in the first days. The brain gradually learns to rely on the balance organ in the other ear. Physiotherapy and simple head and eye exercises help. Do not drive until your team says your balance is safe.
Is radiotherapy always needed afterwards?
Not always. It is more likely when the cancer was large, reached the edges of the removed tissue or had spread to lymph nodes. The pathology report, which describes the removed tissue, decides it. Your team will discuss it with you once the report is ready.
Can this be done through a camera instead of a cut?
This operation is usually done as open surgery, through a cut behind the ear, because the bone needs to come out in one piece where possible. Ask your surgeon to explain the approach they plan and why it suits the extent of your cancer.
What should we bring to the first surgical appointment?
Bring every ear report, biopsy report, CT and MRI scan with the discs or films, and a list of the ear drops and medicines you have used. Bring the family member who will help with decisions and with care at home.
Meet the Specialists
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- National Cancer Institute — Head and Neck Cancers
- Cancer Research UK — Head and neck cancers
- Macmillan Cancer Support — Head and neck cancer
- NHS — Hearing loss
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Hearing after temporal bone surgeryWhat each extent means for hearing, and what helpsFacial nerve risk in skull base surgeryWhy the face can be affected and how the eye is protectedReconstruction of the skull baseHow the space left behind is filledSkull base surgery: what it involvesThe wider picture of surgery at the base of the skullSkull Base and Temporal Bone ResectionEvery page in this guide
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