Treatment of middle ear malignancy includes -
a) Excision of petrous part of temporal bone
b) Subcortical excision
c) Modified radical mastoidectomy
d) None
Most common malignant tumor of middle ear and mastoid is squamous cell carcinoma.
Clinical Features

It affects age group 40–60 years
Slightly more common in females
Most important predisposing cause is long standing CSOM
Patient may present with chronic foul smelling blood stained discharge
Pain is severe and comes at night.
Facial palsy may be seen
O/E – Friable, hemorrhagic granulation or polyp are present.
Diagnosis – made only on biopsy

CT and angiography are done to see the extent of disease.
Metastasis occurs to cervical lymph nodes later.
Treatment of carcinoma of middle ear is combination of surgery followed by radiotherapy.
Surgery consists of radical mastoidectomy / subtotal or total petrosectomy depending on the extent of tumor.
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