Hereditary factors in chronic otitis with cholesteatoma

Hereditary or genetic factors influence the degree of pneumatisation as demonstrated by Schwarz, Dahlberg and Diamant. The angulation at the base of the skull interferes with the anatomical position and patency of the Eustachian tube and leads to impaired pneumatisation of the mastoid. In patients with primary acquired cholesteatoma the angle formed by the clivus, posterior clinoid process and posterior border of the hard palate is significantly smaller than in non-cholesteatomatous patients. The configuration of the epipharyngeal region is considerably different in cholesteatoma carriers than in normal individuals. In cholesteatoma carriers the epipharyngeal lumen is significantly smaller than in normal individuals.