Investigation of Keratinized Squamous Epithelium from Mastoid Cortical Bone Dust in Patients with or without Cholesteatoma

These findings suggest that the mastoid air cell systems of patients with cholesteatoma may be affected differently prior to cholesteatoma spreading to the mastoid system. This could be linked to microcirculation of inflammatory proteins, impaired aeration, and the formation of retraction pouches. These results align with the metaplasia theory as a possible explanation for the etiopathogenesis of acquired cholesteatoma.