Complications of keratosis obturans

External Ear Disease: Keratinaceous Lesions of the External Auditory Canal

Keratosis obturans (KO) and external auditory canal cholesteatoma (EACC) are two distinct keratinaceous lesions of the external ear. This article reviews the signs, symptoms, pathophysiology, workup, and treatment of each. Patients with either pathology can often be managed in the clinic with debridement; however, EACC is more likely to involve osteonecrosis and require more extensive operative management if disease is not confined to the canal on account of the bony erosion characteristic of cholesteatoma. If required for extensive disease, surgical approaches to both pathologies are similar.

Keratosis obturans: A rare cause of facial nerve palsy

Keratosis obturans, caused by the deposition of desquamated keratin plug in the external auditory canal can present with facial palsy. Young patients presenting with facial palsy, earache, and gradual hearing loss should be suspected for Keratosis obturans.

Biochemical composition and antioxidant potential of the edible Mediterranean sea cucumber

The sea cucumber or holothurian is a marine species which has been prized in some Asian coun­tries for its nutritional qualities. The purpose of this work was to study the biochemical composition and free radical scavenging and antioxidant activities of Holothuria tubulosa tegument from the Bizerta lagoon in north­ern Tunisia. The obtained data demonstrated that the extract of sea cucumber teguments exhibited high bio­chemical levels (such as moisture 80.77%, protein 7.07%, lipids 10.21%, energy value 13.64 Kcal/g ww), and an important nutritional value (including n-3/n-6: 2.11, EPA+DHA: 20.96, AI: 1.38 and TI: 0.54). High anti­oxidant activities were recorded in the integument by the radical scavenging tests of ABTS and DPPH as well as by the total antioxidant capacity and the FRAP in comparison with the BHT standard. Our results showed that H. Tubulosa tegument has high nutritional value with high antioxidant activities and could be considered a nutraceutical product.

Butterfly tragal cartilage for repair of focal canal wall defects

BACKGROUND

Meato-mastoid fistula is a connection between the external auditory canal and the mastoid cavity. It may be iatrogenic or pathological. The repair of these focal canal wall defects is necessary to prevent retraction pockets or sequential cholesteatoma and attain relief from otorrhoea.

AIM/OBJECTIVE

To study the effectiveness of an innovative technique for repair of meato-mastoid fistula (less than or equal to 10mm in size) in the bony external auditory canal.

MATERIAL AND METHODS

We performed a retrospective review of 5 surgeries performed in our hospital between January 2017 and December 2017 for the repair of posterior bony canal wall defects. Active ear disease was ruled out before the repair. We used full-thickness butterfly tragal cartilage graft for the repair of these fistulae. All our surgeries were endoscopic and sutureless.

RESULTS

The butterfly tragal cartilage graft was in situ at the repair site and viable on examination at 2 years follow-up, in all our cases.

CONCLUSION AND SIGNIFICANCE

Small posterior canal wall defects can be successfully repaired using this technique. The method is minimally invasive and cosmetic, with good patient compliance. The curling property of the cartilage graft is exploited effectively in this method of repair.

A Wolf in Sheep's Clothing: Keratosis Obturans Causing Facial Nerve Palsy - A Case Report with Review of the Literature

Keratosis obturans is a benign disease caused by layered impaction of wax within the external auditory canal. It presents with acute onset of pain and ear blockade. The current report discusses a 24-year-old male patient with recurrent unilateral keratosis obturans associated with facial canal erosion and resulting in facial palsy. A detailed review of the literature is presented. Keratosis obturans can behave aggressively, resulting in significant erosion of the bone and intratemporal structural damage and complications. Timely intervention is vital.

A Recurrent Misdiagnosed and Maltreated Case of Keratosis Obturans

Keratosis obturans is an obscure entity characterized by accumulation of desquamated keratinous material in the bony portion of the external auditory canal. Patients with this condition typically present with severe otalgia, conductive hearing loss, and global widening of the external auditory canal. We present a case of keratosis obturans that was misdiagnosed as impacted wax. The case was diagnosed and managed by microscope-guided examination with the patient under general anesthesia.

Radiology of external ear: indications, normal anatomy, and pathological processes

The external ear is accessible to direct examination; the clinical history and otoscopy are sufficient to diagnose and treat most diseases of the external ear. We aim to describe the normal anatomy of the external ear, specify the indications for imaging tests, and review the clinical and radiological manifestations of the most common diseases affecting the external ear. We classify these diseases according to their origin into congenital, inflammatory, infectious, or traumatic disease or benign bone tumors or malignant tumors. Imaging does not play an important role in diseases of the external ear, but in certain clinical scenarios it can be crucial for reaching a concrete diagnosis and establishing the best treatment. Computed tomography is the first-choice technique for most diseases. Magnetic resonance imaging complements computed tomography and makes it possible to differentiate among different tissue types and to evaluate the extension of disease accurately.

Therapeutic approaches to complicated cholesteatoma of the external auditory canal: a case of associated facial paresis

Spontaneous cholesteatoma of the external auditory canal (EAC) is an uncommon condition that is difficult to diagnose. In a patient with such a possibility, serious clinical investigation along with radiologic and histologic exploration should be performed early on because a delay in treatment can lead to severe complications. Given the rarity of EAC cholesteatoma, no therapeutic consensus has emerged. The type of management depends on the extensiveness of invasion and bone erosion and the status of the neighboring structures. The primary therapeutic objectives are to eradicate the cholesteatoma and then to fill in the residual cavity, which in our opinion can be best accomplished with a muscle flap and EAC reconstruction. Postoperative follow-up should be carried out to look for infections, stenosis, and recurrence. We report a new case of spontaneous EAC cholesteatoma, and we review its diagnostic and therapeutic challenges.