There appears to be a correlation between ET dysfunction and the subsequent development of a cholesteatoma. Although both a healthy mastoid and adequate ET function seem to be instrumental in providing aeration to the middle ear, the physiologic state of the ET plays a larger role. Postoperative conductive hearing loss and the incidence of reoccurrence of cholesteatoma can be reduced significantly with improved ET function. Several etiologies exist that can cause ETD, which can lead to a wide spectrum of middle ear disease from a mild retraction to an invasive cholesteatoma. However, there are little data to explain why some retractions are stable, while others progress to cholesteatoma. Although some findings have suggested that the degree of aeration of the mastoid is an important physical finding, the key to interrupting this evolution appears to be treatment of the underlying cause of the negative pressure, in this case a poorly functioning ET. Medical intervention has had success in the preventing or treating ETD, whereas surgical treatment has shown to be more effective in addressing the sequelae rather than the cause itself. © 2006 Elsevier Inc. All rights reserved.
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