CHOLESTEATOMA AND CHRONIC OTITIS: Etiologic Problems

Abstract

THE TERM "CHOLESTEATOMA" dates from the beginning of the nineteenth century, created by the anatomist J. Miller, with the implication that the lesion should be regarded as a genuine tumor. According to the pathologists Cruveilhier, Rokitansky and Virchow, cholesteatoma often occurs in the ear but rarely at other places in the skull—for example, in the pia mater or the os petrosum. They did not, however, discard the view that cholesteatoma, even when occurring in the ear, is a genuine tumor. The otologists Gruber (1862) and von Troeltsch (1868) showed that in clinical treatment chronic otitis is frequently found in conjunction with cholesteatoma. They contended that cholesteatoma of the ear—in distinction from that of the pia mater—is not a real tumor and that it is caused by chronic otitis. Brock considered this view to be naheliegend und einleuchtend (reasonable and enlightening). It seems to be generally accepted to this day.¹ In