Cholesteatoma in children: is the disease different in childhood?

During the early phase of the development of the temporal bone the correlation between the bone growth and the formation of the air-filled spaces--disturbed or undisturbed--is decisive for development of even hidden and neglected forms of middle ear cholesteatomata. The second phase of the development of the temporal bone is determined by a slower rate of bone growth when the mucociliary system has to develop its immunobiological capacities. It becomes obvious that the cholesteatoma matrix and perimatrix will find favourable requirements during this early period of life for a rapid spread since the air-filled spaces have not yet reached their final size. Also the correlation to the gas volume will be different when the ratio of the air flow changes.