Temporal bone histopathology of open mastoidectomy cavities

Open cavity mastoidectomy remains the principle surgical treatment of middle ear cholesteatoma in the United Kingdom. A significant proportion of mastoid cavities are prone to intermittent or continuous discharge. In this study the temporal bone histopathology of four patients who had undergone open cavity mastoidectomy is presented. Cavities were predominantly lined with stratified keratinizing squamous epithelium. Residual air cells were obliterated by fibrous tissue, with no evidence of persistent respiratory epithelium. Where inflammatory changes were found, these consisted of areas of granulation tissue in association with epithelial ulceration. Residual cholesteatoma pearls (epidermoids) were not associated with significant inflammatory changes.