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Contemporary management of keratosis obturans: a systematic review

Published online by Cambridge University Press:  05 August 2021

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

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.

Type
Review Article
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.

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