Long-term non-surgical management of canine aural tympanokeratoma with repeated removal of middle ear keratinous debris and CT follow-up

An 8-year-old, male fox terrier with otitis externa was presented because of decreased activity, pain in the ears and deterioration of hearing. Video-otoscopic flushing was performed, revealing yellowish, spongious debris protruding from the left middle ear cavity. The dog was referred to cone beam computed tomography, which revealed non-contrast-enhancing soft tissue opacity filling the left tympanic bulla. Three months later, video-otoscopic removal of keratinous debris from the tympanic bulla was performed, and histological examination of the debris confirmed the presence of tympanokeratoma.
Because the owner refused surgical management, recurrence was followed by video-otoscopic examination and/or computed tomography, and debris removal was repeated when recurrence was observed, altogether four times over 23 months. Four computed tomography scans during the follow-up period revealed only very mild progression of the disease.