Histochemical studies of cholesteatoma

Abstract

Frozen sections of cholesteatomas were compared with postauricular and auditory canal skin and studied using histochemical methods. Several dehydrogenases, lysosomal enzymes and proteolytic activity were studied. Lactate and malate dehydrogenase activity was very strong in the epithelium and subepithelial tissue of cholesteatomas; no succinate dehydrogenase activity was observed. Esterase and acid phosphatase activity was prominent in cells of granulation tissue. Considerable proteolytic activity was observed in these cells and one specimen showed possible extracellular activity. Strong evidence of fat was found in the granulation tissue, particularly at the interface of granulation tissue and bone. In postauricular and auditory canal skin, enzyme activity was generally weaker; no evidence of fat was found. The findings are discussed in the light of other investigations on the importance of enzyme activity in bone destruction associated with cholesteatoma.

Imaging Findings in Auto-Atticotomy

“…8 There are multiple theories to the explain the pathogenesis of bony destruction associated with cholesteatomas, including remodeling from local pressure and recruitment of osteoclasts that are enzymatically active. 9 At imaging (usually CT), a cholesteatoma classically is seen as a soft-tissue mass adjacent to the ossicles with erosion of the ossicles or the scutum. If the cholesteatoma drains spontaneously into the external auditory canal, the bony changes remain but the mass is no longer visualized.…”

Histologische Untersuchungen von Radikalhöhlen*

“…In der Paukenhöhle findet man neben diesen chronischen Gewebsreaktionen auch die Zeichen der akuten Entzün- finden sie sich nicht nur supralabyrinthär, wo sie auch heute noch, im ,,antibiotischen Zeitalter", für die intrakranielien Kompiikationen verantwortlich sind (5), sondern auch im Bereich der Nischen zum ovaien wie zum runden Fenster. -Das deckt sich mit den Angaben anderer Autoren (3,5,14). Für Residualchoiesteaton-ie werden zwei typische Prädilektionsstellen angegeben:…”