PubMed · 5145778
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F R Guilford. 1971. Problems in tympanoplasty.. https://pubmed.ncbi.nlm.nih.gov/5145778/
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A 64-year-old man reported left-sided renal colics recurring regularly every 5-10 months for the past 25 years. After a typical colic urinary sediment was found to contain brownish, flaky elastic material which histologically consisted of nucleus-free keratoid lamellae. Calcium concentration in serum and urine was normal, as were the serum parathormone (215 pg/l) and inorganic phosphate levels. The intravenous pyelogram revealed a polycyclicly circumscribed filling defect (15 x 20 mm) in the left renal pelvis. At ureteroscopy a lamellar brown-grey tumour was identified which arose from the medial wall of the pelvis. Histological examination demonstrated hyper- and parakeratotic hornified squamous epithelium without malignant degeneration. This finding suggested a cholesteatoma originating from squamous epithelial metaplasia. The tumour was removed endoscopically and the renal wall coagulated by laser, a procedure repeated after 3 months. The patient has been free of symptoms for 3 years.
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Controversy still exists concerning the ultimate fate of transposed or transplanted ossicles in tympanoplasty. Histological studies on autologous and homologous ossicles removed at revision operations, or from animal studies, vary in their conclusions. The viability, of such materials used in the long-term is still uncertain. Whether this has any functional significance is also uncertain. This report contains a histological review of 10 ossicle remnants stored in the 'closed' mastoid cavity for 12 months, following closed cavity mastoidectomy (combined approach tympanoplasty).