Otophyma: a case report

Optimizing Management of Otophyma: A Case Series Highlighting the Role of Surgical and Retinoid Therapy

Otophyma is a rare condition that can result in conductive hearing loss. Current otophyma literature does not examine validated treatment outcomes for patients. Utilizing a medical and surgical approach to maintain a patent canal can lead to significant objective improvements. The aim of this case series is to describe a combined successful approach in 3 cases from an academic, multidisciplinary center. The main outcomes analyzed were pre and post air-bone gap audiogram analysis and disimpaction frequency. The results showed that post-management, patient 1 had substantial improvement in hearing, recovering 49 dB in his right ear and 25 dB in his left ear, demonstrating near complete air-bone gap closure. Patient 2 showed a similar dermatologic and functional improvement, although objective audiometric assessment related to otophyma could not be performed due to coexisting chronic otitis media and cholesteatoma. Patient 3, in the 12 months prior to comanagement, had 8 bilateral disimpactions, and following comanagement had 2 disimpactions in 23 months. All 3 patients were pleased with the resultant functional and physical appearance following comanagement. By presenting this approach and objective measures of treatment, we hope to improve future clinical decision-making in a rare condition.

Otophyma, Rhinophyma and Telangiectatic Rosacea - A Rare Combination in a Female Patient

BACKGROUND

Rosacea is an inflammatory facial dermatosis seen more frequently in adults in their second half of life. The phymas are a particular subtype with sebaceous gland hyperplasia and progressive fibrosis.

CASE REPORT

We report on the rare simultaneous occurrence of telangiectatic rosacea, otophyma and rhinophyma in a 50-year-old female with psoriatic arthritis, chronic lymphedema of the legs, and metabolic syndrome.

CONCLUSION

Despite the preference of rhinophyma and otophyma to the male gender, their occurrence in females needs to be considers in the differential diagnosis of dermatoses of head and neck. Early diagnosis and appropriate medical treatment improve outcome and help to avoid surgery.

Otophyma: a rare and frequently misdiagnosed entity

Otophyma is the term used for sebaceous gland hypertrophy and hyperplasia of the ear. It is usually the end stage of rosacea--a common, chronic, cutaneous disorder of unknown etiology. We hereby present a rare case of otophyma with its clinical features, its etiology, diagnosis, and review of medical and surgical therapy. This patient remained undiagnosed and mismanaged for many years before she was finally diagnosed with this rare condition and successfully managed by surgical technique. To our knowledge, this is the second case of otophyma presented in the otolaryngological literature.