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July 1972

Histopathological Study of the Middle Ear Cleft and Its Clinical Implications.

Arch Otolaryngol. 1972;96(1):93. doi:10.1001/archotol.1972.00770090131026

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The authors studied dissections of 50 temporal bones plus some material from labyrhinthectomy cases. Another 1,000 cases were studied clinically using the microscope.

The authors feel that an incus involved in cholesteatoma should never be used. When cholesteatoma is cleaned from off the stapes foot plate, the end result may be sensorineural hearing loss and dizziness, but the authors feel risk is justified. If the foot plate is dislocated, the oval window is covered with a fascia graft. Ossicular homografts are generally preferred to using the patients own incus or malleus in diseased ears.

Distinctions are made between metaplastic epithelium and stratified squamous epithelium in the middle ear, and a definition of "sudden epithelium" is given.

In analyzing the eustachian tubes in these cases, there were no instances where the epithelial lining of the tube was destroyed. Dilatations of the tube with bougies were unsuccessful when there was fibrous stricture.

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