Idiopathic Inflammatory Medial Meatal Fibrotizing Otitis

Abstract

IMFO has its own specific pathophysiologic characteristics, and perhaps also etiopathologic characteristics, which are still unknown.

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

“…2 However, none of the patients in that earlier report developed lichen planus. If the ear canal process in our patients represented an infrequent location of lichen planus, the isomorphic response (Koebner phenomenon) 7 may explain the pathogenesis in this secondary location, following possible initiation via minor, epithelial ear canal trauma.…”

“…The clinical picture of the ear canal process in the presented patients was identical to that in our earlier report of idiopathic, inflammatory, medial meatal, fibrotising otitis. 2 Instead, Martin et al found a hyperkeratotic picture in auditory canal skin. Thus, in most cases of idiopathic, inflammatory, medial meatal, fibrotising otitis, the primary and only site of expression of the epithelial disease is in the medial ear canals.…”

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).…”

“…Concerning the postinflammatory atresia, only 4 cases have been reported in association with children (Table 1). 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).…”