Theory of the Origin of Middle Ear Cholesteatoma and Its Prevention

Overview

On spite of the fact that all theories of the origin of middle ear cholesteatoma are atleast 75 years old, the immense knowledge on their biological behavior and composition and theinformation about their precursors and experimental induction of the defect in animals, theiretiopathogenesis is still not clear. Moreover, in the last fifty years of great changes in therapeuticprocedures treating tube-tympanic inflammations, substantial changes in the appearance of middleear cholesteatomas emerged. The mesoepitympanic cholesteatomas after necrotic otitis disappeared,but mesotympanic forms of cholesteatomas were multiplied, including those below an uninterruptedear drum, as well as the child-age cholesteatomas and those with well-developedpneumatization, where a congenital genesiswas in correctly suspected. The prevention is primarilybased on preventing all types of tube-tympanic inflammations and myringitis, their completehealing up and, secondarily, in the therapy of precursors of cholesteatom, such as drainage andventilation dysfunction of all aerial spaces of middle ear as well as certain kinds of ear drumdystrophy and, thirdly, in a perfect and timely operation on cholesteatoma.

Key words:
cholesteatoma, middle ear, prevention, cholesteatoma.