Explore This IssueOctober 2018
What is the distribution of ciliated epithelium in the human middle ear and its potential role in the formation of cholesteatoma?
The paucity of ciliated epithelial cells on the medial side of the tympanic membrane and the lateral surface of the ossicles in the epitympanum in cases with cholesteatoma and/or chronic otitis media does not support the mucosal migration theory of cholesteatoma formation.
Background: A cholesteatoma is a non-neoplastic epithelial lesion that contains layers of keratin in a cavity lined by keratinizing squamous epithelium and subepithelial connective tissue. Although benign, it can cause serious complications by eroding nearby structures or precipitating infection. Surgical removal of the lesion is considered the only effective medical therapy. There are several theories on the etiopathogenesis of acquired cholesteatoma, including one based on the premise that a squamous pouch is drawn inward by traction exerted by the interaction of opposing ciliated epithelial surfaces of middle ear mucosa on the medial surface of the tympanic membrane and the lateral surface of the ossicles.