title: Histological Changes of the Middle Ear Ossicles Harvested during Cholesteatoma Surgery.
abstract: BACKGROUND
  In the cholesteatoma surgery ossicles can be replaced to reconstruct middle ear function. It is important that these ossicles are free of squamous epithelium, to prevent residual disease. This study focuses on the histological findings of the malleus and incus harvested during cholesteatoma surgery.
  
  
  METHODS
  Eighty middle ears ossicles were examined in vivo and histologically to consider the relationship of cholesteatoma to ossicles, grade of bone destruction and invasion of cholesteatoma to deeper layers of bone.
  
  
  RESULTS
  Serious ossicular destruction was observed more frequently in incus compared to malleus (p=0.0065). Difference of ossicles destruction between children and adults was not significant (p=0.3032). Deep invasion of cholesteatoma into the vascular spaces or inner core of the bone was not observed.
  
  
  CONCLUSIONS
  Autograft ossicles from cholesteatomatous ears should not necessarily be rejected for reconstruction of the ossicular chain. Regarding the histological finding, the authors suggest mechanical cleaning of the ossicle surface to eliminate residual disease.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Lukáš
authors.initials: L
authors.lastname: Školoudík
authors.affiliation: The Fingerland Department of Pathology, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Šimáková
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic. david.kalfert@email.cz.
authors.forename: David
authors.initials: D
authors.lastname: Kalfeřt
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Viktor
authors.initials: V
authors.lastname: Chrobok
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D004429:Ear Ossicles / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D007188:Incus / Q000473:pathology*; D008297:Male; D008307:Malleus / Q000473:pathology*; D008875:Middle Aged; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: Cholesteatoma; Incus; Malleus; Middle ear ossicles; Surgery