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The pathogenesis of granulation tissue that arises periodically around artificial Eustachian tubes was elucidated by histologic examination of 15 cases of tube granuloma. All cases showed the presence of a keratin foreign-body granuloma. The implanted squames incited a foreign-body type of granulomatous reaction and produced a friable vascular exuberant mass that surrounded the artificial Eustachian tube. Histologically, the tube granuloma was characterized by the presence of irregular ovoid slit-like spaces that contained keratin squames, and it was surrounded by foreign-body giant cells.
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Hawke et al. (1981) studied this question.
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