Significance of Langerhans' cells in middle ear cholesteatoma

Recent advances in immunology have opened a new approach to investigating the etiology and pathogenesis of aural cholesteatoma by the immunohistochemical technique. Immunohistochemical and submicroscopic analysis of human cholesteatoma matrices revealed the presence of Langerhans' cells. Several reports have suggested that Langerhans' cells in cholesteatoma are significant, and that the pathogenesis of this disease including bone resorption could be explained as a cell-mediated immune response, but this is still controversial. In this study, Langerhans' cells in cholesteatoma were quantitated and compared with those in postauricular skin and in skin of the open mastoidectomized cavity. The results did not support the hypothesis that Langerhans' cells have a primary role in the development of aural cholesteatoma.