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Contemporary management of keratosis obturans: a systematic review

Published online by Cambridge University Press:  05 August 2021

J A Harounian ,
V A Patel  and
H Isildak
J A Harounian
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Temple University Hospital, Philadelphia, USA
V A Patel
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, USA
H Isildak*
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery | Stony Brook Medicine, New York, USA
*
Author for correspondence: Division of Otolaryngology – Head and Neck Surgery, Department of Surgery | Stony Brook Medicine, Health Science Tower, Level 19, Room 020 Stony Brook, New York 11794-8191 E-mail: mdhuseyin@gmail.com Fax: (631)-444-8947
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Abstract

Objective

This study aimed to examine the medical literature regarding the natural history and management of keratosis obturans.

Method

PubMed was queried via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, and the methodological quality of each study was assessed using the Methodological Index for Non-Randomized Studies criteria.

Results

Fifty-one studies were abstracted, and dual investigator screening resulted in five retrospective studies for final analysis. All studies included patients afflicted with either unilateral (n = 75) or bilateral keratosis obturans (n = 8). The definition of keratosis obturans was present in three studies: a desquamated keratin plug within the external auditory canal. Mean and median Methodological Index for Non-Randomized Studies scores were 9.5 and 9.5, respectively. All patients underwent keratosis obturans exenteration with microscopy. Two studies reported an outcome instrument to evaluate endpoints: marked stillette and audiometry. No complications were observed with follow-up periods from 3 weeks to 3.5 years.

Conclusion

This comprehensive review highlights a lack of published evidence relating to keratosis obturans. However, it appears keratosis obturans treatment is safe and efficacious with identifiable clinical practice patterns.

Keywords

Hearing LossKeratosis ObturansSystematic Review

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 9 , September 2021 , pp. 759 - 764
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr H Isildak takes responsibility for the integrity of the content of the paper

Presented as a poster at the American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting, 13–15 September 2019, New Orleans, Louisiana, USA.

References

Toynbee, J. Specimens of molluscum contagiosum developed in the external auditory meatus. London Med Gaz 1850;46:811Google Scholar
Persaud, R, Hajioff, D, Thevasagayam, M, Wareing, M, Wright, A. Keratosis obturans and external ear canal cholesteatoma: how and why we should distinguish between these conditions. Clin Otolaryngol Allied Sci 2004;29:577–81CrossRefGoogle ScholarPubMed
Bhide, AR, Kale, RV, Pai, RPN, Tepan, MG, Pandit, MS, Raleraskar, AR. An extensive cholesteatoma of the external ear. J Laryngol Otol 1973;87:705–8CrossRefGoogle ScholarPubMed
Mayer, O, Fraser, JS. Pathological changes in the ear in late congenital syphilis. J Laryngol Otol 1936;51:683–714CrossRefGoogle Scholar
Bharadwaj, VK, Walling, KE, Rees, J, Novotny, GM. Necrosis and sequestration in the tympanic part of the temporal bone. J Otolaryngol 1984;13:299–304Google ScholarPubMed
Michaels, L, Soucek, S. Auditory epithelial migration on the human tympanic membrane: II. The existence of two discrete migratory pathways and their embryologic correlates. Am J Anat 1990;189:189–200CrossRefGoogle ScholarPubMed
Corbridge, RJ, Michaels, L, Wright, T. Epithelial migration in keratosis obturans. Am J Otolaryngol 1996;17:411–4CrossRefGoogle ScholarPubMed
Moher, D, Shamseer, L, Clarke, M, Ghersi, D, Liberati, A, Petticrew, M et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1CrossRefGoogle ScholarPubMed
Chakeres, DW, Kapila, A, Lamasters, D. Soft-tissue abnormalities of the external auditory canal: subject review of CT findings. Radiology 1985;156:105–9CrossRefGoogle ScholarPubMed
Revadi, G, Prepageran, N, Raman, R, Sharizal, TA. Epithelial migration on the external ear canal wall in normal and pathologic ears. Otol Neurotol 2011;32:504–7CrossRefGoogle ScholarPubMed
Shinnabe, A, Hara, M, Hasegawa, M, Matsuzawa, S, Kanazawa, H, Yoshida, N et al. A comparison of patterns of disease extension in keratosis obturans and external auditory canal cholesteatoma. Otol Neurotol 2013;34:91–4CrossRefGoogle ScholarPubMed
Park, SY, Jung, YH, Oh, J-H. Clinical Characteristics of keratosis obturans and external auditory canal cholesteatoma. Otolaryngol Head Neck Surg 2014;152:326–30CrossRefGoogle ScholarPubMed
Chong, AW, Raman, R. Keratosis obturans: a disease of the tropics? Indian J Otolaryngol Head Neck Surg 2017;69:291–5CrossRefGoogle ScholarPubMed
Slim, K, Nini, E, Forestier, D, Kwiatkowski, F, Panis, Y, Chipponi, J. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 2003;73:712–6CrossRefGoogle ScholarPubMed
Lesser, S. Keratosis obturans and primary auditory canal cholesteatoma. In: Gleeson, Michael, ed. Scott-Brown's Otolaryngology Head and Neck Surgery, 7th edn. London: Hodder Arnold, 2008;3:3342–5CrossRefGoogle Scholar
Morrison, AW. Keratosis obturans. J Laryngol Otol 1956;70:317–21CrossRefGoogle ScholarPubMed
Tod, H. Specimen of cholesteatoma or keratosis obturans of the external auditory canal. Proc R Soc Med 1910;3:81Google ScholarPubMed