“…These patterns were assessed qualitatively (absent and present) and, when present, were analyzed semi-quantitatively and graded in mild, moderate, and severe depending on their intensity 4,6 . When looking at the hematoxylin-eosin stained specimens in an optical microscope, it was clear that cholesteatomas consist of keratinized squamous stratified epithelium, with four layers identical to those of thin skin (basal, squamous, granulous, and stratum corneum), lying on a bed of connective tissue that contains fibroblasts, lymphocytes, plasmacytes, and e macrophages.…”