A Comparison of Patterns of Disease Extension in Keratosis Obturans and External Auditory Canal Cholesteatoma

Keratosis obturans appears to be an obscure and relatively uncommon entity, even in literature search of journals and reference texts, so much so that there is not even any prevalence or incidence statistics available. However, the condition did not appear to be as uncommon based on our clinical observations. We have managed to obtain 64 patients representing 67 ears with keratosis obturans in our study period of about 18 months with a pattern of occurrence during this period. Humid weather seemed to play a role in the frequency of its appearance during certain period in our observation. There also appears to be a correlation between the severity of symptoms (predominantly pain and hearing loss) and the presenting appearance of the condition, i.e., presence or absence of granulation tissue, as well as that the degree of difficulty in exenteration of the keratosis obturans (matrix and content) depending on the expansion of the bony canal. Our figures showed the majority of the patients are females and young individuals, the majority of them occur unilaterally. The condition also appear to stop short of involving the tympanic membrane with only the bony canal being expanded with the surrounding oedema creating an apparent "canal stenosis".

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“…Although complications such as tympanic membrane perforation have been reported [12] there was none observed in our series.…”

Section: Discussioncontrasting

confidence: 63%

Keratosis Obturans: A Disease of the Tropics?

Chong

Raman

2017

Indian J Otolaryngol Head Neck Surg

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“…In addition, it is difficult to harvest the external auditory canal skin sufficiently. Retroauricular skin does not migrate or form cholesteatoma, unlike external auditory canal skin, 29,30 and therefore differences may be due to inherent properties and not from the formation of cholesteatoma.…”

Section: Discussionmentioning

confidence: 99%

Expression of Apoptotic vs Antiapoptotic Proteins in Middle Ear Cholesteatoma

Chung

Lee

Park

et al. 2015

Otolaryngol.--head neck surg.

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“…In contrast, EACC is characterized by otorrhea and chronic unilateral dull pain secondary to invasion of squamous tissue into a localized area of periostitis in the canal wall. 2,6,7 Patients with EACC typically show ulceration of the canal wall or a defect in the bony canal lateral to the tympanic annulus. 1,[8][9][10] The most common sites of the defects are the posterior and inferior walls, 7 although some reports have indicated involvement of the anterior wall and even circumferential canal involvement, 11 making the differential diagnosis of these 2 diseases difficult.…”

Section: Discussionmentioning

confidence: 99%

“…1,10 Although EACC is likely to be located in the inferior portion of the canal, the thick inferior bony canal causes such progression to be extremely rare. 6 Therefore, the common progression of EACC tends to be in the mastoid cavity via destruction of the posterior bony canal. In the present study, most of the destructive lesions of EACC were restricted to the inferior portion of the bony canal, with 1 case of EACC invading the mastoid cavity.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Keratosis Obturans and External Auditory Canal Cholesteatoma

Park

Jung

2014

Otolaryngol.--head neck surg.

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Objective Keratosis obturans (KO) and external auditory canal cholesteatoma (EACC) have been considered separate entities. While the disorders are distinct, they share many overlapping characteristics, making a correct diagnosis difficult. In the present study, we compared their clinical characteristics and radiological features to clarify the diagnostic criteria. Study Design Retrospective case series. Setting Academic medical center. Subjects and Methods The clinical data of 23 cases of EACC and KO were retrospectively reviewed. The following clinical characteristics were compared between the 2 groups: sex, age, onset of symptoms, follow-up period, audiometric results, and imaging findings on temporal bone computed tomography including bilaterality, location, and the presence of extension to adjacent tissue. Results The mean age of the EACC group was significantly older than that of the KO group. All of the cases of EACC occurred unilaterally, and bilateral occurrences of KO were observed in 4 of 9 cases. All of the lesions in the KO group were circumferential, and no lesion in the EACC group invaded the superior canal wall. No significant differences in symptoms, such as acute otalgia, otorrhea, and hearing loss, were noted between the 2 groups. The incidence of conductive hearing impairment more than 10 dB was higher in the KO group than in the EACC group. Conclusion Thus, KO and EACC are 2 distinct disease entities that share common features in clinical characteristics except for predominant age and bilaterality. Conservative treatment with meticulous cleaning of the lesion was successful in most cases with a long-term follow-up.

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A Comparison of Patterns of Disease Extension in Keratosis Obturans and External Auditory Canal Cholesteatoma

Cited by 22 publications

References 9 publications

Keratosis Obturans: A Disease of the Tropics?

Keratosis Obturans: A Disease of the Tropics?

Expression of Apoptotic vs Antiapoptotic Proteins in Middle Ear Cholesteatoma

Clinical Characteristics of Keratosis Obturans and External Auditory Canal Cholesteatoma

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