ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

No Evidence for Mucosal Migration Theory of Cholesteatoma Formation

by ENTtoday • October 14, 2018

  • Tweet
  • Email
Print-Friendly Version

You Might Also Like

No related posts.

Explore This Issue
October 2018

Comment: There remain several theories that attempt to explain how cholesteatomas develop. All of these have inconsistencies that weaken them. The most recent theory—the mucosal traction theory—is carefully examined by these authors, who ultimately show that, like the others, this theory is flawed. —Andres Bur, MD

What is the distribution of ciliated epithelium in the human middle ear and its potential role in the formation of cholesteatoma?

Bottom line
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.

Histological analysis of the middle ear space. (A) Slide from a left ear, at the level of the pars flaccida, showing the space where the ciliated cells were counted at the epitympanum: lateral side of the malleus and incus, and medial side of the lateral wall. The light blue area represents the area where the ciliated cells were counted (H&E, 1 × magnification). (B) The arrow shows the flat epithelium located at the lateral side of the malleus (H&E, 10 × magnification). (C) The arrow shows the flat epithelium located at the medial side of the lateral wall at the epitympanum (H&E, 10 × magnification). (D) Histological view of the respiratory-like epithelium that covers the lateral wall of the protympanum toward the Eustachian tube. The arrowheads show the goblet cells located at this space (H&E, 40 × magnification). CP = cochleariform process; EAC = external auditory canal; FN = facial nerve; H&E = hematoxylin and eosin; HSCC = horizontal semicircular canal; I = incus; M = malleus; TM = tympanic membrane. Credit: © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Histological analysis of the middle ear space. (A) Slide from a left ear, at the level of the pars flaccida, showing the space where the ciliated cells were counted at the epitympanum: lateral side of the malleus and incus, and medial side of the lateral wall. The light blue area represents the area where the ciliated cells were counted (H&E, 1 × magnification). (B) The arrow shows the flat epithelium located at the lateral side of the malleus (H&E, 10 × magnification). (C) The arrow shows the flat epithelium located at the medial side of the lateral wall at the epitympanum (H&E, 10 × magnification). (D) Histological view of the respiratory-like epithelium that covers the lateral wall of the protympanum toward the Eustachian tube. The arrowheads show the goblet cells located at this space (H&E, 40 × magnification). CP = cochleariform process; EAC = external auditory canal; FN = facial nerve; H&E = hematoxylin and eosin; HSCC = horizontal semicircular canal; I = incus; M = malleus; TM = tympanic membrane.
Credit: © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

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.

Pages: 1 2 | Single Page

Filed Under: Literature Reviews, Otology/Neurotology Tagged With: CholesteatomaIssue: October 2018

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • What Happens to Medical Students Who Don’t Match?
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why We Get Colds
    • Some Challenges Remain to Having a Universal Resident Leave Policy, But Otolaryngology Programs Are Getting Closer
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • What Happens to Medical Students Who Don’t Match?
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • Neurogenic Cough Is Often a Diagnosis of Exclusion
    • Why We Get Colds
    • Are the Jobs in Healthcare Good Jobs?
    • What Really Works in Functional Rhinoplasty?
    • Is the Best Modality to Assess Vocal Fold Mobility in Children Flexible Fiberoptic Laryngoscopy or Ultrasound?
    • Three Primary Treatment Strategies Show No Differences in Swallow Outcome for Patients with Low- to Intermediate-Risk Tonsil Cancer

Polls

Do you have physician assistants in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2023 The Triological Society. All Rights Reserved.
ISSN 1559-4939