title: Ectopic apocrine glands as a predisposing factor for postinflammatory medial meatal fibrosis: a clinicopathologic study.
abstract: OBJECTIVE
  To illuminate pathophysiologic processes in postinflammatory medial meatal fibrosis (PMMF), a rare otologic disease of unknown etiology, which is defined by a progressive, obliterating fibrosis that affects the osseous part of the external auditory canal (EAC) exclusively.
  
  
  METHODS
  Retrospective clinical and histopathologic study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Eleven patients (4 female and 7 male subjects) who underwent surgery of the bony EAC due to PMMF (13 ears operated).
  
  
  METHODS
  Histologic and immunohistochemical assessment of tissue specimens obtained during surgical excision.
  
  
  METHODS
  Detection of ectopic apocrine glands and concomitant inflammatory infiltrate within tissue harvested from the osseous EAC.
  
  
  RESULTS
  Additionally to expected histologic findings, such as excessive fibrosis and a chronic inflammatory infiltrate, ectopic spread of apocrine glands was consistently detected in all of our patients.
  
  
  CONCLUSIONS
  Based on our findings, we suggest that an ectopic occurrence of adnexal structures within the bony EAC may predispose susceptible individuals to the development of PMMF. To avoid postoperative recurrence due to iatrogenic spread of cutaneous adnexal structures during surgery, the split-thickness skin graft should not exceed a thickness of 0.4 mm.
authors.affiliation: *Department of Otorhinolaryngology and †Department of Dermatology, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Moser
authors.forename: Michael
authors.initials: M
authors.lastname: Emberger
authors.forename: Miklós
authors.initials: M
authors.lastname: Tóth
authors.forename: Sebastian
authors.initials: S
authors.lastname: Roesch
authors.forename: Gerd
authors.initials: G
authors.lastname: Rasp
authors.forename: Martin
authors.initials: M
authors.lastname: Laimer
mesh_terms: D000328:Adult; D001050:Apocrine Glands; D002828:Choristoma / Q000473:pathology*; D004424:Ear Canal / Q000473:pathology* / Q000601:surgery; D004427:Ear Diseases / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies