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Keratosis Obturans
Keratosis Obturans
Keratosis Obturans
Keratosis Obturans
Keratosis obturans:
is accumulation of desquamated keratin in the external auditory meatus. This should be differentiated from primary auditory canal
cholesteatoma which is characterized by invasion of squamous tissue from the external ear canal into a localized area of bone erosion.
Pathology:
The keratin plug seen in keratosis obturans appears like a geometrically patterned keratin plug within the lumen of expanded ear canal.
These keratin squames are shed from the complete circumference of the deep ear canal forming a lamina. It appears like onion skin.
Etiology:
Keratosis obturans is postulated to occur due to abnormal epithelial migration of ear canal skin. The movement of the surface
epithelium appears to be reversed in these patients. (The surface epithelium over pars accida migrates downwards to the pars tensa
and then moves inferiorly across the drum).
Keratosis tympanicum:
Is also caused by abnormal migration of squamous epithelium lining the deep portion of the external auditory canal. This condition is
also associated with unilateral tinnitus.
Clinical features:
On examination:
The ear canal appears to be widened, making the ear drum stand out. CT scan of temporal bones may reveal canal erosion and
widening.
After surgical removal under general anesthesia the specimen must be sent for pathological evaluation to rule out malignancy.
Management:
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