Stratum corneum barrier lipids in cholesteatoma

Specimens from primary cholesteatomas were examined under the electron micr oscope using: a lipid-retaining method that is best suited for intracellula r lipids and a method that is best for intercellular lipids. In the stratum granulosum of the squamous epithelium, a large number of Odland bodies eme rged. When the corneocyte reaches the transitional stage to the stratum cor neum, the Odland bodies accumulate near the cell membrane and discharge the ir contents of lipid and enzymes. The lipids are reorganized into multiple long sheets of lamellar structures that embrace the keratinized corneocytes , as seen in the formation acid maintenance of the cutaneous permeability b arrier. In this study we draw the attention to the facts that the cholestea toma epithelium is capable of producing not only cholesterol, but also seve ral lipids, and that the lipid molecules are organized in multilamellar str uctures in the intercellular space. In theory. the failure to desquamate se en in cholesteatomas could be caused by partial or total failure of Odland body delivery to the intercellular region, or to local breakdown of the per meability barrier.