A Recurrent Misdiagnosed and Maltreated Case of Keratosis Obturans

Alarouj, Hamoud; Alobaid, Faisal; AlBader, Abdulmohsen; Ebrahim, Mahmoud

doi:10.1155/2019/9095747

Cited by 6 publications

(3 citation statements)

References 16 publications

(22 reference statements)

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“…Today, EACC is a rather rare condition, accounting for one case per 1000 new otological patients (Hertz & Sliim, 2018). With four to five cases per 1000 new otological patients, KO is slightly more frequent (Alarouj et al, 2019 and references therein). EACC and KO share numerous characteristics, and until the 1980s, the two terms were used interchangeably as it was assumed that EACC and KO represented the same disease process (Naiberg et al, 1984).…”

Section: Introductionmentioning

confidence: 99%

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Abnormal bone loss in the external auditory canal of two adult humans from the medieval period of Germany—An attempt at differential diagnosis

Flohr

Kierdorf

2022

Intl J of Osteoarchaeology

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Abnormal loss of bone in the external auditory canal (EAC) constitutes an underreported condition in paleopathology. Thus far, all reported cases were diagnosed as the result of an external ear canal cholesteatoma (EACC). Here, we report two cases from the medieval period in Germany that show enlarged EACs with perforations of the anterior and posterior EAC walls. The cases were studied macroscopically, with a digital stereo microscope and by conventional X‐ray and computed tomography (CT)‐imaging techniques. In Case 1, the resorption caused a “ballooning” of the EAC while signs of osteonecrosis were missing. We therefore conclude that keratosis obturans (KO) is the most likely diagnosis. In Case 2, the periantral region adjacent to the perforations of the posterior EAC wall exhibits large resorption cavities and sequestrum‐like structures, indicative of osteonecrosis. In this case, we arrive at the diagnosis EACC. Ear diseases encompass a broad spectrum of conditions, many of them with potentially severe impacts on past people. It is therefore suggested to address ear diseases more frequently in paleopathology. Thus far, only a very limited number of entities of ear diseases have been diagnosed in paleopathological studies, and no case of KO has been reported. The present study thus expands the spectrum of paleo‐otopathological diagnoses.

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Section: Introductionmentioning

confidence: 99%

“…Instead, KO causes a generalized circumferential widening of the EAC (Piepergerdes et al, 1980). Osseous changes caused by KO are described as ballooning of the EAC, which in advanced cases can lead to an annulus "suspended in the air" (Alarouj et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Abnormal bone loss in the external auditory canal of two adult humans from the medieval period of Germany—An attempt at differential diagnosis

Flohr

Kierdorf

2022

Intl J of Osteoarchaeology

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“…A common misdiagnosis includes keratosis obturans, a pathology characterized as an accumulation of keratin that results to a soft tissue plug with generalized widening of the ear, and cholesteatoma, which presents with osteonecrosis and sequestration along with ottorhea [ 1 , 4 ]. Both pathologies obliterate the ear canal, which is not a characteristic present in benign osteonecrosis of the external ear.…”

Section: Discussionmentioning

confidence: 99%

Benign osteonecrosis of the external ear canal: case series

Chandler¹,

Hawthorne²,

Georgolios³

2023

Journal of Surgical Case Reports

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Benign osteonecrosis of the external ear canal is a rare pathology that commonly gets misdiagnosed as cholesteatoma of the external ear canal, keratosis obturans and malignant otitis externa. Each pathology has characteristics that allow for differentiation between them. Careful analysis is required to diagnose properly and determine the best modality of management. This case series presents two patients that were diagnosed with benign osteonecrosis of the external ear canal and is being managed conservatively with serial debridement. Response to conservative treatment has resulted in adequate control of symptoms in both patients.

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