Since the year 1850, when Toynbee first described the condition, there have appeared occasional articles in the literature and in textbooks, chiefly German, concerning a chronic desquamative process of the external auditory canal. It is usually secondary to a protracted hyperemia of the canal, which may have been started by otitis media, furunculosis, inflammation of adjacent structures or infection in the nose. Usually by the time the patient comes under the observation of a physician the canal is filled with a greasy, more or less discolored plug consisting of cerumen, débris, desquamated epithelium and cholesterol. On removal, it is found to be a cast of the external meatus with the imprint of the annulus tympanicus and the membrana tympani on it. The external surface is glistening white with newly desquamated cells and cholesterol. The membrana tympani is intact, but it may be distorted by pressure and rarely is eroded. There
GREENE LD. CHOLESTEATOMA-LIKE ACCUMULATIONS IN THE EXTERNAL AUDITORY MEATUS. Arch Otolaryngol. 1933;18(2):161–167. doi:10.1001/archotol.1933.03580060175003
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