Abstract
The cause of bone destruction in cases of cholesteatoma has been considered to be pressure necrosis and enzymatic substances from the matrix and desquamated epithelial debris. Kaneko, et al., based on observation of materials from various parts of the middle ear in 100 surgical cases of cholesteatoma, reported that in such cases, bone destruction was found in the vicinity of the rupture.
We found bone destruction in the vicinity of the rupture of the cholesteatoma sac in the temporal bone of a 45-year-old female. Cholesteatoma with desquamated epithelial debris was seen in the attic portion. Cholesteatoma sac was ruptured in the malleus head and in a part of the external auditory canal. The bone destruction and granulation with infiltration by lymphocytes and giant cells in the subepithelial layer were seen especially in the ruptured portions. From these facts, the escape of contents from the sac of cholesteatoma into the subepithelial layer is considered to be an important factor in the mechanism of bone destruction.
