CASE REPORT Treatment of Otophyma: Case Report and Review of the Literature

Abstract

Objectives: Otophyma is a rare condition that can present as the end stage of any chronic inflammatory disease affecting the ear such as rosacea, eczema, or otitis externa. It can result in conductive hearing loss, low self-esteem, and social embarrassment. This report highlights a case of otophyma treated successfully using a full-thickness skin graft.

Methods: We present a case of a 41-year-old lady referred to our department with a 23-year history of bilateral otophyma. During this time, her hearing progressively diminished as the swelling occluded her external auditory meatus. She had been unsuccessfully managed for years with topical emollients, steroids, and regular ear toileting.

Result: She was treated by excision of the phymatous tissue and full-thickness grafting, which resulted in a patent external auditory meatus and an improvement in her hearing.

Conclusions: The use of a full-thickness skin graft is one of the many treatment options available for the treatment of otophyma. We present a literature review on this uncommon condition and a discussion on the various treatment options available to the patient.

Figure 1

Images illustrating the preoperative appearance of bilateral otophyma secondary to chronic eczematous otitis externa with the right ear showing signs of infection (top). Preoperative pure tone audiograms illustrating conductive deafness worse on right compared to the left (bottom).

Figure 2

Postoperative images illustrating graft take on right ear 2 weeks postprocedure (left). Postoperative pure tone audiogram illustrating improvement in conductive deafness of the right ear (right).