Keratosis obturans complicated with facial nerve palsy: a diagnostic dilemma

Keratosis obturans: A rare cause of facial nerve palsy

“…1 According to Piepergerdes et al, KO is mostly encountered in the age group <40 while EACC is encountered in the age group 45-75 1. However, the cases reported in the articles reviewed for this study show only 50% of patients are under 40 years of age, 22 years being the minimum 2,[4][5][6][7][8]. Bony erosions in the cases of KO and EACC are different that is, it is extensive in the case of KO and relatively localized in the case of EACC 1.…”

“…KO can also be of the silent type caused by the abnormal separation of keratin without inflammation and faulty migration of epithelium. 7 This type of KO keeps recurring after the first removal of the keratin plug, therefore, requires continuous ear toileting.…”

A Recurrent Misdiagnosed and Maltreated Case of Keratosis Obturans

“…These findings were consistent with those of our patient intraoperatively. A soft tissue plug in the bilateral external ear canal with evidence of ballooning of the osseous part are the common findings in computed tomographic scans of patients with KO [ 4 ].…”

“…Removal of the keratin can cure the inflammatory type. The silent type is caused by abnormal separation of the keratin leading to the continuous progression of the disease, even after the first removal; thus, continuous regular aural toileting is required to treat the disease [ 4 ]. In addition, patients with KO not associated with inflammation of the canal skin will need lifelong periodic aural toileting because of the local metabolic deficiency that affects the normal migratory mechanism [ 14 ].…”

“…Although the condition was first described by Tonynbee in 1850, the term KO was first used by Wreden in 1874 who discriminated the condition from impacted ear wax [ 2 , 3 ]. The characteristic clinical features include severe otalgia and hearing loss due to the collection of a desquamated epidermal plug in the ear canal [ 4 ]. The estimated incidence of KO is four to five patients per 1000 new otological cases [ 5 ].…”