EPITHELIAL MIGRATION IN PARS FLACCIDA CHOLESTEATOMA

M.Amatsu, K.Makino, H.Ishida, and H.Maeno

Dept of ENT, Kobe University School of Medicine

Kobe, Japan

Epithelial migration is a very important self-cleansing property in the tympanic membrane and external canal which carries the keratin layer outward for removal. Our previous study disclosed that the cholesteatoma sac without keratin debris accumulation has the migratory property.

In this study, a dry cholesteatoma sac with a keratin sheet in postero-superior canal wall, which suggested the migratory course, was examined to confirm the significance of the keratin sheet as a migratory route. A marker solution of Pyoktanin Blue dye was painted in the sac and its migratory course was examined endoscopically with video recording.

Most of the dye in the sac migrated posteriorly to the postero-superior canal wall where the keratin sheet was seen earlier. It took one year for the maker dye to travel in the sac and on the canal. This fact suggests that the keratin sheet on the canal indicates the migratory course in the cholesteatoma sac and on the canal.