IS CHOLESTEATOMA A VIRUS-INDUCED TUMOR

It is yet unknown why under certain circumstances the benign epitheliu m covering the outer ear canal in a protective role causes an erosion of bony structures after migration into the middle ear. Histologically , a papillomatous growth and clusters of koilocytes are typical featur es of the aggressively growing, bone-destructive areas of the choleste atoma. Since these resemble the characteristics of a papilloma, biopsi es originating from cholesteatomas were examined for the presence of h uman papillomavirus (HPV) DNA. Findings demonstrated that HPV-11-relat ed DNA was present in one such lesion. In general, papilloma viruses n eed specific conditions to be able to replicate and induce a papilloma tous growth. Retraction pockets of epithelium, junction lines between squamous epithelium and mucosa as well as inflammatory processes may s timulate this replication. Because these conditions are characteristic for cholesteatoma, we therefore suggest a possible papillomavirus eti ology for the development of aggressive cholesteatoma.