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Thirteen chronically infected temporal bones were serially sectioned and stained to study the characteristics of any possible squamous epithelium. Non-cholesteatomatous epithelium is either immigrative or metaplastic in origin and the choles-teatomatous always immigrative. The metaplastic epithelium does not keratinize and the non-cholesteatomatons immigrative slightly keratinizing type may change into cholesteatomatous aggressive type only in the presence of at present unknown inductors.
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Karma et al. (1973) studied this question.
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