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Chapter-05 Surgical Pathology

BOOK TITLE: Tragal Cartilage in Middle Ear Reconstruction

Author
1. Desarda KK
ISBN
9788184487305
DOI
10.5005/jp/books/11097_5
Edition
1/e
Publishing Year
2009
Pages
6
Author Affiliations
1. KEM Hospital, Pune, Maharashtra, India, King Edward Memorial Hospital, Pune, Maharashtra, India; BJ Medical College, Pune, Maharashtra, India
Chapter keywords

Abstract

Microscopically, there are changes in the epithelium, submucosa and the bony tissue like: 1. Loss of fibrous layer therefore thinning the membrane which perforates easily. 2. The simple squamous epithelium undergoes metaplasia to stratified squamous epithelium. 3. There is marked proliferation of granulation tissue. 4. Increased vascularity with thickened walls of blood vessels. 5. Infiltration by round cells macrophages and lymphocytes. 6. There is destruction of the bone adjacent to marrow spaces. 7. It is observed that inflammatory process may be the cause of a Defect in tympanic membrane, which gives way easily for the middle ear fluid under tension to escape out side. 8. Hyperemia and chronic inflammation may be the probable causes of bone resorption, instead of a vascular necrosis which was preciously thought to be the cause of bone destruction, in cases of chronic supportive otitis media (Sade 20, 21, 22). 9. Collagenase has been demonstrated in cholesteatoma matrix and macrophages are supposed to be a source of collagenase (Abramson 1) which is responsible for bone destruction or even the sheer weight of the choesteatoma sac along with its keratin contents, is postulated to cause pressure necrosis and erosion of the ossicles. 10. In adhesive otitis media, adhesive changes may affect tympanic membrane, the middle ear cavity, ossicular chain and the mastoid air cells. Many times, the middle ear cavity is replaced by masses of scar tissue and often there is absorption of bone affecting the ossicular chain.

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