Electron microscope study of bone lesion in cholesteatoma otitis

Biopsy specimens were obtained at ear surgery of patients with cholesteatoma otitis and were studied by electron microscopy. The osseous tissue decalcified in EDTA demonstrated degradation of collagen matrix as well as extensive degeneration of bone cells. The surface of the eroded bone was found to be in direct contact with the subepithelial connective tissue or the granulation, but not with the keratinizing squamous epithelium of matrix. These results indicate that the bone destruction by cholesteatoma is of non-osteoclastic type and lend support to the view that the keratinizing squamous epithelium do not participate in bone destruction. One the ultrastructural basis, the inflammatory process in the soft tissue adjacent to bone and extensive degeneration of bone cells are considered as cardinal factors for bone destruction in this disease.