Giuseppe Attanasio, Mammola CL, Covelli E, Cagnoni L, De Seta D, Minni A, Gaudio E and Filipo R
Objective: The aim of the study is to define, just before any sort of cleaning procedure, if there is any epithelial inclusion inside the ossicles of patients with cholesteatoma and if the findings could be correlated with surgical aspect of cholesteatoma.
Methods: The specimens used for this study were 19 malleus and 15 incuss which were intraoperatively obtained from 24 patients. Each ossicles was grouped on the basis of cholesteatoma intraoperatively aspect as follows: Stage 1: ten ossicles obtained from encapsulated cholestatoma, non-invasive, easily cleavable. Stage 2: fourteen ossicles obtained from partially encapsulated cholesteatoma, non-invasive, non-easily cleavable. Stage 3: ten ossicles obtained from not encapsulated cholesteatoma, invasive, not cleavable. Two stapes and 1 malleus have been taken from patients who underwent middle ear surgery for conductive hearing loss and they have been used as control. The ossicles were examined histopathologically after the removal.
Results: Our results do not show any epithelial inclusion inside the ossicles independently from the macroscopic aspect or growing aggressiveness of cholesteatoma. In addition there was not inflammatory cells infiltration in stage 1, but it was present in one incus (7.1%) of stage 2 and in five ossicles (50%) of stage 3. In ossicles of grade 3 it has been found up to four layers of epithelial cells on the surface of the ossicles.
Conclusion: The results of the present study reject the hypothesis that epithelial inclusions into the ossicles could cause cholesteatoma recurrences, but strongly suggest to perform safe cleaning procedure of ossi
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