Evidence against neonatal aspiration of keratinizing epithelium as a cause of congenital cholesteatoma.

Abstract

It has been suggested that congenital cholesteatoma may be caused by perinatal aspiration of squamous epithelium. Microscopic study of fetal temporal bones. Thirty-one temporal bones from infants who died of sudden infant death syndrome before 1 year of age and 27 temporal bones obtained from preterm fetal deaths aged 4 to 8 months of fetal development were studied to assess signs of aspiration of squamous epithelium in the middle ear. None of the prenatal or postnatal temporal bones showed keratinizing epithelial cells or lanugo. A certain number of specimens displayed a nonspecific inflammatory lymphocytic infiltration. The data in the present study do not support the theory of amniotic fluid and squamous epithelial aspiration as an origin of congenital cholesteatoma.