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

OBJECTIVES/HYPOTHESIS: It has been suggested that congenital cholesteatoma may be caused by perinatal aspiration of squamous epithelium.

STUDY

DESIGN

Microscopic study of fetal temporal bones.

METHODS

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.

RESULTS

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.

CONCLUSION

The data in the present study do not support the theory of amniotic fluid and squamous epithelial aspiration as an origin of congenital cholesteatoma.