Idiopathic, inflammatory, medial meatal, fibrotising otitis presenting with lichen planus

Abstract

The aetiopathology or pathophysiology of idiopathic, inflammatory, medial meatal, fibrotising otitis may be linked with lichen planus. Early, active treatment of idiopathic, inflammatory, medial meatal, fibrotising otitis with local corticosteroids may prevent total medial meatal atresia.

Idiopathic Inflammatory Medial Meatal Fibrotizing Otitis Presenting in Children

“…formation of the ear canal atresia has started to develop, the treatment is difficult; the atretic process proper is not preventable anymore (4,7). The chronically inflamed, and damaged skin is prone to (repeated) purulent infections causing granulation, which certainly accelerates the final atresia formation (3,4,7). However, a meticulous treatment of infections and granulations does not stop the process, and, seemingly, the infection is not a causative factor in the progression of the medial meatal inflammation and relentlessly developing atresia proper.…”

“…In neither of our IMFO cases was the use of topical antibiotics in the inflammatory stage beneficial. Potent local corticosteroid treatment instead of antiseptic or antibiotic ear drops lessens most effectively the symptoms and also controls the progression of atresia (4,7). Possibly, the process resulting in atresia formation can even be prevented if the epithelial destruction caused by inflammation can be reversed or averted with corticosteroid treatment started early enough (7).…”

“…We have earlier suggested idiopathic inflammatory medial meatal fibrotizing otitis (IMFO) to be a specific subgroup with a defined clinical pathologic finding inside the postinflammatory category of acquired ear canal atresias (4). In adults, an association to lichen planus is possible with IMFO (7). Because of the rarity of the condition, the pathologic process is difficult to recognize and diagnose before the atresia is already far in development.…”

Lichen planus of the external auditory canal: Treatment options and review of literature

“…Usually, LP involves not only the skin, typically on flexural surfaces of the limbs, but also the mucosae are frequently affected, in the oral and genital district. 2 Even if 0.3%-0.8% of the population is reported to present some forms of lichen planus, the otic localization of LP is thought to be extremely rare and only two single case reports 3,4 and two small case series 5,6 are published in the scientific literature, for a total of 24 reported patients.…”

Acquired atresia and stenosis of the external acoustic meatus

“…В большинстве случаев это конечная стадия гранулирующего наружного отита. Некоторые авторы уделяют немаловажную роль в развитии приобретенной атрезии сопутствующим кожным заболеваниям [27]. Так, в исследовании I. Dhooge и соавт.…”