Topical applications of 5-fluorouracil in the medical treatment of cholesteatoma of the middle ear.

Recent studies have demonstrated that aural cholesteatoma features intense DNA turnover in the germinative layer of the matrix and an immune response in the wall of the cyst, which trigger a chain reaction. 5-Fluorouracil, an antimetabolitic agent that is also effective topically, was applied to the cyst wall in the initial cholesteatoma, in relapsing cholesteatoma (even transtympanically) and in large exudative cavities resulting from attico-antrectomy: in all cases, it inhibited the formation of keratin and reduced the mucous hypersecretion. These results have persisted even after 12 months of suspending treatment.