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

Abstract

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.

Assessment of hearing loss in patients with rosacea

“…In the literature, there are reported cases with conductive hearing loss in rosacea patients with otophyma mainly due to the obstruction of the external auditory canal by otophyma. 14,15 Since rosacea is thought of as an autoimmune-related inflammatory disease with vascular abnormalities, and the underlying immunologic mechanisms may affect the cochlea of the patients with rosacea, we aimed to evaluate the presence of a sensorineural hearing loss in patients with rosacea in comparison with the healthy control group and also to compare the hearing test results according to the severity of disease among the patient group. To the best of our knowledge, this is the first study that evaluates hearing loss in patients with rosacea.…”

“…Although many comorbidities including autoimmune disorders are more in patients with rosacea than healthy controls, to the best of our knowledge, hearing loss in these patients has not been evaluated up to now. In the literature, there are reported cases with conductive hearing loss in rosacea patients with otophyma mainly due to the obstruction of the external auditory canal by otophyma 14,15 . Since rosacea is thought of as an autoimmune‐related inflammatory disease with vascular abnormalities, and the underlying immunologic mechanisms may affect the cochlea of the patients with rosacea, we aimed to evaluate the presence of a sensorineural hearing loss in patients with rosacea in comparison with the healthy control group and also to compare the hearing test results according to the severity of disease among the patient group.…”