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March 1993

Morphologic Development of Experimental Cholesteatoma

Author Affiliations

From the Departments of Otorhinolaryngology (Drs Åberg and Edström) and Pathology (Dr Kindblom), University of Göteborg, Sweden, and the Department of Otorhinolaryngology, University of Stockholm (Sweden) (Dr Bagger-Sjöbäck).

Arch Otolaryngol Head Neck Surg. 1993;119(3):272-275. doi:10.1001/archotol.1993.01880150020003

• Using light microscopy, we studied the morphologic events of cholesteatoma progression 8 months after ligation of the ear canal in 14 Mongolian gerbils. Although we observed a wide range of progression, four stages of morphologic development could be clearly distinguished among the 28 specimens: stage I, an orthokeratotic plug in the ear canal without tympanic membrane involvement; stage II, partial retraction of the tympanic membrane; stage III, the interface between cholesteatoma encapsulated within the tympanic membrane and mucosal membranes covering the promontorial wall of the middle-ear cavity was characterized by a buildup of granulation tissue with prominent macrophage infiltration; and stage IV, bone destruction. Chronic inflammation was observed in some but not all stage II to IV cases. Our results indicate that hyperkeratosis is a primary event in cholesteatoma development, that the development of the granulation tissue with activated macrophages may be responsible for the bone destruction, and that acute or chronic inflammation is not a prerequisite for the development of cholesteatoma or the bone resorptive process.

(Arch Otolaryngol Head Neck Surg. 1993;119:272-275)

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