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Updated: Jul 17, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Histologic description of acquired cholesteatomas: comparison between children and adults
Cristina Dornelles1, Luíse Meurer, Sady Selaimen da Costa
1Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, University Hospital of Porto Alegre, Brazil.
Insights
Histologic analysis revealed no morphologic differences between pediatric and adult cholesteatomas. Inflammation and matrix cellularity correlate with perimatrix thickness, suggesting a predictor of cholesteatoma aggressiveness.
Area of Science:
- Otolaryngology
- Pathology
- Pediatric Surgery
Background:
- Cholesteatoma, a destructive epithelial growth in the middle ear, comprises matrix, perimatrix, and cystic content.
- Clinical observations suggest more aggressive behavior in pediatric cholesteatomas compared to adults.
Purpose of the Study:
- To histologically compare cholesteatomas from pediatric and adult patients.
- To identify potential morphologic differences and their correlation with clinical behavior.
Main Methods:
- Analysis of 74 cholesteatomas (35 pediatric, <18 years).
- Evaluation of matrix cellular layers and hyperplasia.
- Assessment of perimatrix thickness, epithelium, fibrosis, inflammation, and granuloma.
- Statistical analysis using SPSS 10.0 with Pearson, Spearman, chi-square, and t-tests.
Main Results:
- No significant morphologic differences were identified between pediatric and adult cholesteatomas.
- A significant correlation (rs=0.5, P<0.0001) was found between inflammation degree, matrix cellularity, and perimatrix thickness.
- Perimatrix thickness averaged 80 micrometers, with moderate to severe inflammation in 60% of cases.
Conclusions:
- Morphologic distinctions between pediatric and adult cholesteatomas were not established.
- Inflammation intensity and matrix cellularity correlate with perimatrix thickness, potentially indicating aggressiveness.
- Further research is needed to elucidate the role of these findings in cholesteatoma pathogenesis.
Unlabelled:
Cholesteatoma is constituted of matrix, perimatrix and cystic content. Some authors affirm that, in children, its clinical behavior is more aggressive of the than in adults.
Aims:
Histologic compared cholesteatomas of children and adults.
Methodology:
74 cholesteatomas been analyzed, being 35 of pediatrics patients (<18 years). The average number of cellular layers and hyperplasia in the matrix had been evaluated; thickness, delimitante epithelium, fibrosis, inflammation and granuloma in the perimatrix. The analysis statistics was carried through with program SPSS 10.0, using the coefficients of Pearson and Spearman, test of chi-square and t test. The number of cellular layers in the matrix was of 8.2+/-4.2. The hyperplasia appears in 17%, fibrosis in 65%, granuloma in 12% and the delimitante epithelium in 21%. The perimatrix presented a medium one of 80 micrometers (37 the 232), minimum value zero and maximum value 1.926. The histological degree of inflammation was considered of moderate the accented one in 60%. When applying the coefficient of Spearman enters the inflammation degree and average of cellular layers of the matrix with the variables of the measure of thickness of the perimatrix we find correlations, significant, with moderate magnitudes of the great ones (rs=0.5 and P<0.0001).
Conclusion:
Adults colesteatomas of and child had not been identified to morphologic differences between. We find correlation enters the intensity of the inflammation and of the average of cellular layers of the matrix with the thickness of the perimatrix, what it can predict its aggressiveness, more studies are necessary to define the paper of this finding in pathogenesis of cholesteatoma.
