Keratosis obturans: Difference between revisions
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__NOTOC__ | |||
{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S]][mailto:ravitheja.g@gmail.com] | {{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S]][mailto:ravitheja.g@gmail.com] | ||
{{SI}} | {{SI}} | ||
==Overview== | ==Overview== | ||
Keratosis obturans is accumulation of desquamated keratin in the [[external auditory meatus]]. It is common in young patient population. | |||
==Pathophysiology== | ==Pathophysiology== | ||
Keratosis obturans is thought to occur due to abnormal epithelial migration of ear canal skin. The movement of the surface epithelium appears to be reversed in these patients. These keratin squames are shed from the complete circumference of the deep ear canal forming a lamina. It appears like onion skin. There exists 3 types of Keratosis obturans depending upon the pathology. They are: | |||
* Inflammatory type - it may be caused due to viral infection | * Inflammatory type - it may be caused due to viral infection | ||
* Silent type - it is caused by abnormal separation of the keratin of the ears | * Silent type - it is caused by abnormal separation of the keratin of the ears | ||
* Primary auditory canal cholesteatoma - it is caused by trauma to the external ear canal. Hearing impairment is not found in this type of keratosis obturans. | * Primary auditory canal cholesteatoma - it is caused by trauma to the external ear canal. Hearing impairment is not found in this type of keratosis obturans. | ||
==Risk | ==Risk Factors== | ||
* [[Sinusitis]] | * [[Sinusitis]] | ||
* [[Bronchiectasis]] | * [[Bronchiectasis]] | ||
==Diagnosis== | |||
== | ===History and Symptoms=== | ||
* Partial [[hearing loss]] | * Partial [[hearing loss]] | ||
* [[Otalgia]] | * [[Otalgia]] | ||
* [[ | * [[Otorrhea]] | ||
* Associated [[sinusitis]] or [[bronchitis]] may be present. | * Associated [[sinusitis]] or [[bronchitis]] may be present. | ||
== | ===CT=== | ||
* CT scan of temporal bones may reveal canal erosion and widening<ref name="pmid22180115">{{cite journal |author=McCoul ED, Hanson MB |title=External auditory canal cholesteatoma and keratosis obturans: the role of imaging in preventing facial nerve injury |journal=Ear Nose Throat J |volume=90 |issue=12 |pages=E1–7 |year=2011 |month=December |pmid=22180115 |doi= |url=}}</ref> | * CT scan of temporal bones may reveal canal erosion and widening.<ref name="pmid22180115">{{cite journal |author=McCoul ED, Hanson MB |title=External auditory canal cholesteatoma and keratosis obturans: the role of imaging in preventing facial nerve injury |journal=Ear Nose Throat J |volume=90 |issue=12 |pages=E1–7 |year=2011 |month=December |pmid=22180115 |doi= |url=}}</ref> | ||
* | |||
===Other Diagnostic Studies=== | |||
* Surgical specimen after surgery should be sent for pathology testing to rule out malignancy. | |||
==Treatment== | ==Treatment== | ||
* Surgical removal | ===Surgery=== | ||
* Surgical removal is the main stay of treatment | |||
* Canal plasty - in case of recurrence | * Canal plasty - in case of recurrence | ||
* [[Mastoidectomy]] - in the | * [[Mastoidectomy]] - in the primary auditory canal cholesteatoma type | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
[[Category: | [[Category:Disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Grammar]] | [[Category:Grammar]] | ||
Latest revision as of 17:09, 27 February 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S[2]
Overview
Keratosis obturans is accumulation of desquamated keratin in the external auditory meatus. It is common in young patient population.
Pathophysiology
Keratosis obturans is thought to occur due to abnormal epithelial migration of ear canal skin. The movement of the surface epithelium appears to be reversed in these patients. These keratin squames are shed from the complete circumference of the deep ear canal forming a lamina. It appears like onion skin. There exists 3 types of Keratosis obturans depending upon the pathology. They are:
- Inflammatory type - it may be caused due to viral infection
- Silent type - it is caused by abnormal separation of the keratin of the ears
- Primary auditory canal cholesteatoma - it is caused by trauma to the external ear canal. Hearing impairment is not found in this type of keratosis obturans.
Risk Factors
Diagnosis
History and Symptoms
- Partial hearing loss
- Associated sinusitis or bronchitis may be present.
CT
- CT scan of temporal bones may reveal canal erosion and widening.[1]
Other Diagnostic Studies
- Surgical specimen after surgery should be sent for pathology testing to rule out malignancy.
Treatment
Surgery
- Surgical removal is the main stay of treatment
- Canal plasty - in case of recurrence
- Mastoidectomy - in the primary auditory canal cholesteatoma type