Naiberg J, Berger G, Hawke M
Arch Otolaryngol. 1984 Oct;110(10):690-3. doi: 10.1001/archotol.1984.00800360062016.
The presence of a keratin plug occluding the deep external auditory canal was first noted and documented in the 19th century. It has subsequently been proposed that two different diseases can be responsible for the presence of this type of obstruction within the deep meatus: keratosis obturans and external auditory canal cholesteatoma. Keratosis obturans is characterized by a dense plug of keratin debris located primarily within the deep meatus. There is an associated hyperplasia of the underlying epithelium and evidence of chronic inflammation within the subepithelial tissue. There is no evidence of erosion or necrosis of the underlying bone. In external auditory canal cholesteatoma the significant finding is extensive erosion of the bony external auditory canal by a wide-mouthed sac, lined with stratified squamous keratinizing epithelium, that arises lateral to the tympanic membrane and is located in the inferior portion of the bony external canal. There is frequently evidence of sequestration of the underlying bone.
19世纪首次发现并记录了角质栓阻塞外耳道深部的情况。随后有人提出，外耳道深部出现这种类型的阻塞可能由两种不同疾病引起：外耳道角化症和外耳道胆脂瘤。外耳道角化症的特征是主要位于外耳道深部的致密角质碎屑栓。其下方上皮组织有增生，上皮下组织有慢性炎症迹象。没有证据表明下方骨质有侵蚀或坏死。在外耳道胆脂瘤中，显著发现是一个大口囊广泛侵蚀骨性外耳道，该囊内衬有分层鳞状角化上皮，起源于鼓膜外侧，位于骨性外耳道下部。常有下方骨质坏死的证据。
