Research vistas in chronic otitis media

In spite of recent major advances in our knowledge of the basic factors in diseases of bone and mucosa the mechanisms responsible for the development of cholesteatoma are still not known for certain. The role of connective tissue in determining the histologic character of the overlying epithelium deserves more attention. It is possible that more radical removal of connective tissue from the mastoid would result in a lower incidence of post operative cholesteatoma. A study of human temporal bones provides little evidence that retraction pockets are caused by underlying scar tissue. Although a vast weight of suspicion indicts malfunction of the Eustachian tube as the primary cause of chronic middle ear disease, the proof is lacking providing a supreme challenge for otologists of the future.