In 160 cases of chronic otitis media with cholesteatoma in the epitympanum and intact ossicular chain, histological analysis of the incus was performed. The ossicles were cut in serial sections and every five cuts analysed. The findings were normal in 10.7%, a fibrous thickening of the periost was found in 13% of the cases. In 8% of the cases there was fibrosis of the periost with foci of active inflammation. Ostitis or osteomyelitis in the bone itself was present in 67.5%. In conclusion, removal of the ossicle during tympanoplasty was deemed necessary in 67.5% of the cases since otherwise relapse of the inflammatory process could sooner or later be expected.
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