Alzheimer’s disease and ear SCC

Consult: 91-Year-old man for consideration of excision of ear SCC and possible temporal bone flap resection.


  • Early Alzheimer’s dementia
  • No major cardiorespiratory co-morbidities
  • Chronic pain – previous issues with opioid analgesia exacerbating cognitive decline, stable on current regime of Ibuprofen, Paracetamol and PRN Oxycodone


  • Mild Alzheimer’s dementia – regular review by geriatrician over the last 4 years.
  • MoCA score 20/30. Montreal Cognitive assessment Tool. See
  • Lives independently with wife in a retirement village, happy with current QoL
  • SCC right ear, increasing in size despite previous resection


  • Significant risk of both reversible and irreversible cognitive decline. 
  • Patient and wife understand this risk and are keen to proceed.
  • Non-surgical option would be radiotherapy however, patient lives rurally and would have to travel to Port Macquarie every day for treatment. 
  • Both patient and his wife feel that radiotherapy would be create significant stress to their current lives. 
  • Untreated SCC is an unpleasant disease with significant pain and lifestyle limitations


  • Proceed to surgery as planned