The formation of epithelial plugs of considerable size must be counted among the rare diseases of the ear. In my practice, private and hospital, extending over more than a quarter of a century, I have met with only two cases. The literature of the subject also confirms their rarity. They would appear to be allied in nature to cholesteatomata, described by Mueller and Virchow as pearl tumor, possessing a well marked wall with contents of hornified or epidermized cells arranged in layers like an onion. The same description applies to the tumor described by Habermann as occurring in the mastoid antrum, many examples of which are recorded. In the cases which I report there did not appear to be any middle ear involvement in so far as epithelial growth was concerned, though there was a history of previous suppurative trouble in both. Further, the removal of the growth from the
RYERSON GS. KERATOSIS OBTURANS. JAMA. 1906;XLVII(25):2051–2052. doi:10.1001/jama.1906.25210250005001a
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