What is Obturans Keratosis?
Keratosis obturans, also known as keratosis obturans syndrome, is a rare condition that affects the ear canal. It is characterized by the excessive buildup of keratin, a protein found in the skin, within the ear canal. This buildup can lead to the formation of hard plugs or masses that can cause partial or complete blockage of the ear canal. Keratosis obturans is distinct from the more common condition called earwax impaction, where an excessive accumulation of earwax causes a blockage.
Here are some key points about keratosis obturans:
Causes:
The exact cause of keratosis obturans is not well understood. It is believed to involve a disruption in the normal shedding of dead skin cells within the ear canal, leading to the accumulation and hardening of keratin.
Symptoms:
Individuals with keratosis obturans may experience symptoms such as:
- Hearing loss or decreased hearing in the affected ear.
- Sensation of fullness or blockage in the ear.
- Pain or discomfort in the ear.
- Tinnitus (ringing or buzzing sound in the ear).
- Dizziness or imbalance (rare).
Diagnosis:
A diagnosis of keratosis obturans is typically made through a combination of medical history, physical examination, and visualization of the ear canal using an otoscope. Additional imaging tests, such as a CT scan, may be performed to assess the extent of the blockage and rule out other possible causes.
Stages:
| Grade | Feature |
|---|---|
| Grade I | Mild pain ± ear block with the presence of accumulated keratin enveloped by a tightly adherent matrix; no discernible expansion of external canal |
| Grade II | Moderate to severe pain ± conductive deafness; presence of accumulated keratin enveloped by a tightly adherent matrix with mild expansion of the bony canal in the presence of keratosis obturans. |
| Grade III | Moderate to severe pain ± conductive deafness; presence of accumulated keratin enveloped by a tightly adherent matrix with expanded bony canal with granulation tissue at the osteo-cartilaginous junction. |
| Grade IV | Presence of accumulated keratin enveloped by a tightly adherent matrix (grade III) with exposure of the mastoid air cells with/without facial nerve involvement |
