Pathogenesis of Cholesteatoma

  • Tamotsu Morimitsu


There are several different theories that attempt to explain the etiology of cholesteatoma. The three most popular original theories are (1) the retraction pocket theory states that cholesteatoma forms by accumulation of debris in retraction pockets arising from Shrapnell’s membrane or from the adhered pars tensa, caused by occlusion of the eustachian tube (Bezold 1908); (2) the migration theory states that squamous epithehum which has migrated into the middle ear through a perforated tympanic membrane proliferates there (Habermann 1889); and (3) the metaplastic theory states that squamous metaplasia of the middle ear mucosa forms following chronic inflammation (Wendt 1873).


Otitis Medium Acute Otitis Medium Eustachian Tube Chronic Otitis Medium Retraction Pocket 
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  1. Barfoed C, Rösberg J (1980) Secretory otitis media: long-term observation after treatment with grommets. Arch Otolaryngol 106:553–556PubMedCrossRefGoogle Scholar
  2. Bezold F (1908) Textbook of otology (trans, by Holinger H). Colgrove, Chicago, p 189Google Scholar
  3. Brik HG, Mravec JT (1976) Myringotomy for middle ear effusions: results of two-year study. Ann Otol Rhinol Laryngol 85(suppl 25):263–267Google Scholar
  4. Draf W (1980) Insertion of ventilation tubes into the middle ear: results, complications—a seven-year review. Ann Rhinol Laryngol 89(suppl 68):303–307Google Scholar
  5. Gunderson T, Tönning F-M (1976) Ventilation tubes in the middle ear: long-term observations. Arch Otolaryngol 102:198–199CrossRefGoogle Scholar
  6. Habermann J (1889) Zur Entstehung des Cholesteatoms des Mittelohrs. Arch Ohrenheilk 27:42–46CrossRefGoogle Scholar
  7. Hara Y, Kano K, Masuda M, Toyama K, Matsuda K, Tsuboi Y, Morimitsu T (1991) Clinical results of ventilation tube therapy of otitis media with effusion (in Japanese with English abstract). Otol Fukuoka 37:557–561Google Scholar
  8. Hara Y, Hidaka S, Tono T, Makino K, Kasano F, Ide M, Enatsu K, Ushisako Y, Morimitsu T (1983) Clinical results of secretory otitis media (in Japanese). Clin Otol Jpn 10:266–267Google Scholar
  9. Karma P (1982) Long-term results of tympanotomy treatment in chronic secretory otitis media. Acta Otolaryngol (Stockh) Suppl 386:163–165CrossRefGoogle Scholar
  10. Kokko E (1976) Clinical results and complications of tympanostomy. Ann Otol Rhinol Laryngol 85(suppl 25):277–279PubMedGoogle Scholar
  11. Mackinnon DM (1971) The sequel to myringotomy for exudative otitis media. J Laryngol Otol 82:773–793Google Scholar
  12. Makino K, Inaba J, Tono T, Morimitsu T (1995) Evaluation of surgical procedure for adhesive cholesteatoma (in Japanese with English abstract). Otol Jpn 5:26–31Google Scholar
  13. Mawson SR, Fagan P (1972) Tympanic effusion in children: long-term results of treatment by myringotomy, aspiration, and indwelling tubes (grommets). J Laryngol Otol 86:105–119PubMedCrossRefGoogle Scholar
  14. McLelland CA (1980) Incidence of complications from use of tympanotomy tubes. Arch Otolaryngol 106:97–99PubMedCrossRefGoogle Scholar
  15. Miyanaga S, Morimitsu T (1989) A planimetric study of temporal bone pneumatization in cholesteatoma. In: Tos M, Thomsen J, Peitersen E (eds) Cholesteatoma and mastoid surgery. Kugler Ghedini, Amsterdam, pp 259–263Google Scholar
  16. Morimitsu T (1991) Etiology of middle ear cholesteatoma (in Japanese with English abstract). Otol Fukuoka 37:271–405Google Scholar
  17. Morimitsu T, Kano K (1990) Prevention of cholesteatoma: is it possible or not? (in Japanese). Otolaryngol Head Neck Surg 16:28–32Google Scholar
  18. Muenker G (1980) Results after treatment of otitis media with effusion. Ann Otol Rhinol Laryngol 89(suppl 68):308–311Google Scholar
  19. Onishi T (1983) Development of cholesteatoma from otitis media with effusion (in Japanese with Enghsh abstract). Otolaryngol Tokyo 55:691–696Google Scholar
  20. Proctor B (1989) Surgical anatomy of the ear. Blackwell, OxfordGoogle Scholar
  21. Sade J (1976) Atelectasis and secretory otitis media. Ann Otol Rhinol Laryngol 85:66–73PubMedGoogle Scholar
  22. Suzuki M, Modera K, Yamada O (1983) Long-term observation of secretory otitis media in children (in Japanese). Clin Otol 10:240–241Google Scholar
  23. Tos M, Poulsen G (1976) Secretory otitis media: late results of treatment with grommets. Arch Otolaryngol 102:672–675PubMedCrossRefGoogle Scholar
  24. Wendt H (1873) Desquamative Entzundung des Mittelohrs. Arch Ohrenheilk 14:428–432Google Scholar
  25. Wittmaack K (1933) Wie entstehet ein genuines Cholesteatoma? Arch Ohren-Nasen-Kehlkophheilkunde 137:306–332CrossRefGoogle Scholar
  26. Yokoyama T (1984) Treatment in secretory otitis media—how to choose grommets (in Japanese). Otolaryngol Tokyo 56:833–841Google Scholar

Copyright information

© Springer-Verlag Tokyo 1997

Authors and Affiliations

  • Tamotsu Morimitsu
    • 1
  1. 1.Miyazaki Medical CollegeMiyazakiJapan

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