Epithelial Proliferation in Cholesteatoma

Objective Comparison of the proliferative potential of pediatric cholesteatoma with that of adult cholesteatoma, using Ki‐67 as a proliferation marker. Method Prospective study on 67 patients with aural cholesteatoma from 2003 to 2005. Thirty‐eight adult and 29 pediatric cases were evaluated using clinical parameters, including bone erosion, complications, and extent of disease. Histological evaluation of cholesteatoma and measurement of the proliferation index using Ki‐67 labeling was performed. Normal skin specimen from a control group was also examined. Results Final assessment could be performed in 28 adult and 25 pediatric cholesteatoma cases and 12 controls. The mean Ki‐67 labeling index of cholesteatoma cases was 29.2 out of 200 (14.6%). The mean index for controls was 19 out of 200 (9.5%), significantly lower than cholesteatoma group (P =. 033). The mean Ki‐67 labeling index was 33.5 per 200 in pediatric cases and 26.5 per 200 in adult cases. Though proliferation index was higher in pediatric cases, difference was insignificant (P =. 13). Pediatric cholesteatoma was also similar to adult cholesteatoma in terms of complications, bone erosion, and disease spread. Conclusion Cholesteatoma is a disorder of epithelial proliferation. Although postulated to be more aggressive in children than adults, this study found no pathological differences between pediatric and adult cases.