The pathogenesis and treatment of cholesteatoma.
Congenital cholesteatoma, which arises from embryonic epidermoid tissue, is rare. In the majority of cases the cholesteatoma is acquired. It may develop as a retraction pocket involving the whole membrane, as a result of migration over the perforation edges or as basal cell invasion behind an intact membrane. There is no evidence for a metaplastic process or a Langerhans' cell mediated origin. Treatment modalities include several methods of either conservative or radical surgery, the main aim being one-stage total eradication of cholesteatoma and simultaneous reconstruction. With appropriate surgical methods recurrence figures after 5 years should remain under 10%. The patient's own tissues are the material of choice in the reconstruction.
Palva
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Department of Otolaryngology, University of Helsinki, Finland.
D002781:Cholesteatoma / Q000209:etiology / Q000601:surgery; D004427:Ear Diseases / Q000209:etiology / Q000601:surgery; D004432:Ear, Middle / Q000601:surgery; D006801:Humans