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March 1953


AMA Arch Otolaryngol. 1953;57(3):245-256. doi:10.1001/archotol.1953.00710030265001

A DISCUSSION of the mode of genesis and the pathology of the various types of cholesteatoma is essential to a full understanding of the problems involved in selecting cases for and carrying out the technique of the modified radical mastoidectomy. In some instances the final decision as to whether this type of operation will be adequate cannot be made until the pathology is exposed at the time of surgery.

CHOLESTEATOMA  Cholesteatoma is generally defined as a mass of concentric layers of cast-off epithelial cells surrounded by a matrix of squamous epithelial cells and connective tissue, the epithelium being on the inner surface of the matrix. Fatty degeneration and cholesterol-crystal formation occur in the desquamated epithelium. There are numerous classifications of cholesteatoma, including such divisions as true, pseudo, congenital, acquired, primary, and secondary. A review of the literature reveals considerable confusion in terminology. Since the histological appearance is essentially the same