Ear block.... due to not so common condition

Whenever ear is blocked, some people start using wax solvents, thinking of wax. There are numerous cases for  ear block, can be due to  external canal  swelling, wax, fungal ball, furuncle, middle ear causes. Keratosis obturans( KO) is one cause. 

KO is characterized by accumulation of large plug of desquamated (shedded) keratin in the ear canal, causing widening of the canal. Two types are there, silent  KO and  other one following a viral infection. 

Some of my patients had involvement of both ears with associated seborrhoeic dermatitis and dandruff ( younger age groups). Another patient  was  in his 60's with diabetes and ear was infected. 

KO presents with ear ache and decreased hearing, sometimes granulations and bone erosion .Some cases, association with sinusitis and lung conditions are documented. 

Keratosis Obturans  need to be diagnosed early and proper treatment should be given to prevent complications. Sometimes there will be associated fungal infection also as shown in the picture (  with patient's  permission)