Definition

Keratosis obturans (KO) is the buildup of keratin in the ear canal. Keratin is a protein released by skin cells that form the hair, nails, and protective barrier on the skin.

Causes

The exact cause of KO is unknown. It may be due to a problem with how skin cells in the ear canal are produced. Or, it may be caused by overstimulation of the wax glands by the nervous system.

Symptoms

Symptoms may include:

• Mild to severe pain
• Reduced hearing ability
• Inflammation of ear canal

Exams and Tests

Your health care provider will examine your ear canal. You will also be asked about your symptoms.

A CT scan or x-ray of the head may be done to help diagnose the problem.

Treatment

KO is usually treated by removing the buildup of material. Medicine is then applied to the ear canal.

Outlook (Prognosis)

Regular follow-ups and cleaning by your provider are important to avoid infections. In some people, lifetime cleaning may be needed.

When to Contact a Medical Professional

Contact your provider if you feel pain in the ear or difficulty in hearing.

References

Naples JG, Brant JA, Ruckenstein MJ. Infections of the external ear. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 138.

Ying YLM. Keratosis obturans and canal cholesteatoma. In: Myers EN, Snyderman CH, eds. Operative Otolaryngology-Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 128.