Keratosis Obturans

Keratosis obturans is a very painful condition of the ear. It is caused due to excessive accumulation of the keratin debris in the bony external canal probably due to faulty migration of the epithelium.
This presentation aims to explain the definition, etiology, clinical features and treatment of keratosis obturans.

1. Keratosis obturans
•Keratoticmassofdesquamatedepitheliuminbony
portionofEACobstructingit
•Pearlywhite/obscuredbywax
•Commonage :5-20yrs
•Etiology
–Idiopathic
–Chronichyperemiadesquamationofkeratin
epidermaldebris
–Faultymigrationofsquamousepithelialcells
–Maybeassociatedwithbronchiectasis&sinusitis

2. Clinical Features
•Severepainintheearwithauralfullness
–Bilateralsymptomsinchildren
–Unilateralpredominantlyinadults
•Hearingloss(conductive),otorrhea(rare),
tinnitus
•Geometricallypatternedkeratinplugwithin
thelumenofexpandedearcanal(onionskin)
•Erosionandabnormalwideningofdeep
osseousmeatus(eburnatedbonycanal,
ballooningofEAC)
•TMusuallyintact
•Mucopurulentdischarge(rare)

3. Treatment
•Removal of the Keratotic debris by
instrumentation (LA /GA)
•Treatment of inflammation
•Keratolytic -not helpful
•Canalplasty (recurrent cases)
•Regular follow –up , May recur!!