Pediatric middle ear cholesteatoma: the comparative study of congenital cholesteatoma and acquired cholesteatoma

2015 ◽  
Vol 273 (5) ◽  
pp. 1155-1160 ◽  
Author(s):  
Yuka Morita ◽  
Yutaka Yamamoto ◽  
Shinsuke Oshima ◽  
Kuniyuki Takahashi ◽  
Sugata Takahashi
Keyword(s):  
Comparative Study ◽  
Middle Ear ◽  
Congenital Cholesteatoma ◽  
Middle Ear Cholesteatoma ◽  
Acquired Cholesteatoma ◽  
The Comparative Study

scholarly journals Animal Models of Middle Ear Cholesteatoma

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Tomomi Yamamoto-Fukuda ◽  
Haruo Takahashi ◽  
Takehiko Koji
Keyword(s):  
Hearing Loss ◽  
Bone Resorption ◽  
Animal Models ◽  
Middle Ear ◽  
Future Prospect ◽  
Pathological Condition ◽  
Current Status ◽  
Morphologic Characteristics ◽  
Middle Ear Cholesteatoma ◽  
Acquired Cholesteatoma

Middle ear acquired cholesteatoma is a pathological condition associated with otitis media, which may be associated with temporal bone resorption, otorrhea and hearing loss, and occasionally various other complications. Cholesteatoma is characterized by the enhanced proliferation of epithelial cells with aberrant morphologic characteristics. Unfortunately, our understanding of the mechanism underlying its pathogenesis is limited. To investigate its pathogenesis, different animal models have been used. This paper provides a brief overview of the current status of research in the field of pathogenesis of middle ear acquired cholesteatoma, four types of animal models previously reported on, up-to-date cholesteatoma research using these animal models, our current studies of the local hybrid ear model, and the future prospect of new animal models of middle ear cholesteatoma.

Role of Langerhans cells, Ki-67 protein and apoptosis in acquired cholesteatoma: prospective clinical study

2013 ◽  
Vol 127 (3) ◽  
pp. 252-259 ◽  
Author(s):  
V Akdogan ◽  
I Yilmaz ◽  
T Canpolat ◽  
L N Ozluoglu
Keyword(s):  
Middle Ear ◽  
Langerhans Cells ◽  
Prospective Clinical Study ◽  
Ear Canal ◽  
Ki 67 ◽  
Middle Ear Cholesteatoma ◽  
Proliferation And Apoptosis ◽  
Acquired Cholesteatoma ◽  
Open Versus

AbstractObjective:To investigate the role of Langerhans cells in the pathogenesis and clinical picture of middle-ear cholesteatoma.Subjects and methods:The study included 40 patients operated upon for a diagnosis of chronic otitis due to acquired cholesteatoma.Results and analysis:A closed surgical technique was used in 20 per cent of patients and an open technique in 80 per cent. Langerhans cells were more densely accumulated in cholesteatoma epithelium, compared with external ear canal skin (p < 0.001). Staining for Ki-67 protein was greater in cholesteatoma epithelium (p < 0.001) and Apo2.7 protein staining (indicating apoptosis) was more prominent (p < 0.001), compared with ear canal skin. Regarding significant relationships between clinical and pathological findings, staining for Ki-67 (p = 0.046) and Apo2.7 (p = 0.037) was more prominent in patients undergoing open versus closed surgery.Conclusion:Using cell proliferation and apoptosis markers, a dense Langerhans cell infiltration was found to occur as a host response to middle-ear cholesteatoma.

Evidence-based review of aetiopathogenic theories of congenital and acquired cholesteatoma

2007 ◽  
Vol 121 (11) ◽  
pp. 1013-1019 ◽  
Author(s):  
R Persaud ◽  
D Hajioff ◽  
A Trinidade ◽  
S Khemani ◽  
M N Bhattacharyya ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Squamous Metaplasia ◽  
Retraction Pocket ◽  
Erosive Disease ◽  
Congenital Cholesteatoma ◽  
Inflammatory Conditions ◽  
Acquired Cholesteatoma ◽  
Stratified Squamous Epithelium

AbstractCholesteatoma is a non-neoplastic, keratinising lesion which has two forms: congenital and acquired. Congenital cholesteatoma develops behind a normal, intact tympanic membrane, whilst acquired cholesteatoma is associated with a defect in the tympanic membrane. The pathological substrate of cholesteatoma is keratinising stratified squamous epithelium, but the origin of this epidermal tissue in the middle ear is controversial. Here, we review the most relevant and recent evidence for the principal aetiopathogenic theories of both forms of cholesteatoma, in the light of recent otopathological findings.Congenital cholesteatoma is most plausibly explained by the persistence of fetal epidermoid formation. Conclusive ‘proof’ awaits the unambiguous demonstration of the metamorphosis of an epidermoid nidus into a lesionin vivo.Acquired cholesteatoma may develop by various mechanisms: immigration, basal hyperplasia, retraction pocket and/or trauma (iatrogenic or non-iatrogenic). However, squamous metaplasia of the normal cuboidal epithelium of the middle ear is a highly unlikely explanation. Chronic inflammation seems to play a fundamental role in multiple aetiopathogenic mechanisms of acquired cholesteatoma. Therefore early treatment of inflammatory conditions might reduce their sequelae, perhaps by preventing the development of hyperplastic papillary protrusions.Continued otopathological, cellular and molecular research would enhance our limited understanding of cholesteatoma and may lead to new therapeutic strategies for this erosive disease, which often defies surgical treatment.

Congenital cholesteatoma assessment based on staging and classification criteria for middle ear cholesteatoma proposed by the Japan Otological Society

2020 ◽  
Author(s):  
Masahiro Miura ◽  
Yutaka Yamamoto ◽  
Masahiro Takahashi ◽  
Manabu Komori ◽  
Kazuhisa Yamamoto ◽  
...  
Keyword(s):  
Middle Ear ◽  
Classification Criteria ◽  
Congenital Cholesteatoma ◽  
Middle Ear Cholesteatoma

scholarly journals Expression of tumor necrosis factor Alpha, interleukin-1 and matrix metalloproteinase-9 and pathomorphological changes in acquired middle ear cholesteatoma

2021 ◽  
Vol 12 (1) ◽  
pp. 29-38
Author(s):  
Dalibor Vranješ ◽  
Predrag Špirić ◽  
Mirjana Gnjatić
Keyword(s):  
Middle Ear ◽  
Interleukin 1 ◽  
Tympanic Cavity ◽  
Middle Ear Mucosa ◽  
Necrosis Factor Alpha ◽  
Middle Ear Cholesteatoma ◽  
Acquired Cholesteatoma ◽  
Factor Alpha ◽  
Metalloproteinase 9 ◽  
Mucosal Hypertrophy

Introduction. The inflammatory mediators play a central role in the pathogenesis of the inflammatory process of the middle ear and cholesteatoma from the aspect of initiating and maintaining the inflammatory response to infection and lesion. The aim of the study was to examine if the presence of acquired cholesteatoma could predict pathomorphological changes of the tympanic cavity mucosa in relation to the control tissue of the inflamed middle ear mucosa and to examine and compare the expression levels of tumor necrosis factor-alpha (TNF-a), interleukin-1 (IL-1) and matrix metalloproteinase 9 (MMP-9) with pathomorphological changes in the middle ear mucosa in chronic otitis media (COM), with and without acquired cholesteatoma (AC). Methods. The immunohistochemical study included 178 patients of both sexes, aged 5 to 75, who underwent microsurgical treatment of COM from 2015 to 2018. Patients were divided into two groups based on the presence or absence of AC of the middle ear: 97 with cholesteatoma (CCOM) and 81 without cholesteatoma (COM). Samples of the perimatrix of AC and inflamed middle ear mucosa were taken intraoperatively. The condition of the tympanic cavity mucosa was examined by otomicroscopy exploration intraoperatively. The expression levels of TNF-a, IL-1 and MMP-9 were determined by immunohistochemical analysis. Results. The difference in the percentage distribution of patients according to the condition of the tympanic cavity mucosa between both groups was statistically significant (p <0.01) where in the COM group the highest frequency was 43.2% of patients with mucosal hypertrophy, and in the CCOM 56.7% with granulations. With highly positive expression of TNF-R2 and IL-1, a higher probability of the presence of mucosal hypertrophy and granulations can be expected, and with highly positive expression of MMP-9 the presence of granulations. Conclusion. Acquired middle ear cholesteatoma is a statistically significant predictor of the occurence of mucosal hypertrophy and granulations in the tympanic cavity in relation to the control tissue of the inflamed middle ear mucosa. The high expression of TNF-R2, IL-1 and MMP-9 shows a statistically significant association with the presence of granulations and mucosal hypertrophy in acquired middle ear cholesteatoma which may have clinical significance in the evaluation and prognosis of the disease.

Bilateral Occurrence of Congenital Middle Ear Cholesteatoma

2002 ◽  
Vol 127 (5) ◽  
pp. 480-482 ◽  
Author(s):  
Mohamed A. El-Bitar ◽  
Sukgi S. Choi
Keyword(s):  
Middle Ear ◽  
Early Stage ◽  
Congenital Cholesteatoma ◽  
Pediatric Age Group ◽  
Middle Ear Cholesteatoma ◽  
Long Term Follow Up ◽  
Group A ◽  
High Index Of Suspicion

Congenital cholesteatoma of the middle ear is a relatively rare entity that is becoming more frequently encountered in the pediatric age group. A high index of suspicion is needed to recognize this entity at an early stage. More challenging is the bilateral occurrence of the lesion that, although still rare, should always be remembered when examining children with congenital cholesteatoma, not only on the initial visit but also on subsequent follow–up. We report the eleventh case of bilateral congenital middle ear cholesteatoma and stress the importance of long–term follow–up in these cases.

Nationwide survey of congenital cholesteatoma using staging and classification criteria for middle ear cholesteatoma proposed by the Japan Otological Society

2019 ◽  
Vol 46 (3) ◽  
pp. 346-352 ◽  
Author(s):  
Yuka Morita ◽  
Tetsuya Tono ◽  
Masafumi Sakagami ◽  
Yutaka Yamamoto ◽  
Keiji Matsuda ◽  
...  
Keyword(s):  
Middle Ear ◽  
Nationwide Survey ◽  
Classification Criteria ◽  
Congenital Cholesteatoma ◽  
Middle Ear Cholesteatoma

scholarly journals Updates and Knowledge Gaps in Cholesteatoma Research

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Chin-Lung Kuo ◽  
An-Suey Shiao ◽  
Matthew Yung ◽  
Masafumi Sakagami ◽  
Holger Sudhoff ◽  
...  
Keyword(s):  
Middle Ear ◽  
Management Strategy ◽  
Clinical Presentation ◽  
Management Strategies ◽  
Effective Management ◽  
Comprehensive Understanding ◽  
Middle Ear Cholesteatoma ◽  
Acquired Cholesteatoma ◽  
Intracranial Complications ◽  
Extracranial Complications

The existence of acquired cholesteatoma has been recognized for more than three centuries; however, the nature of the disorder has yet to be determined. Without timely detection and intervention, cholesteatomas can become dangerously large and invade intratemporal structures, resulting in numerous intra- and extracranial complications. Due to its aggressive growth, invasive nature, and the potentially fatal consequences of intracranial complications, acquired cholesteatoma remains a cause of morbidity and death for those who lack access to advanced medical care. Currently, no viable nonsurgical therapies are available. Developing an effective management strategy for this disorder will require a comprehensive understanding of past progress and recent advances. This paper presents a brief review of background issues related to acquired middle ear cholesteatoma and deals with practical considerations regarding the history and etymology of the disorder. We also consider issues related to the classification, epidemiology, histopathology, clinical presentation, and complications of acquired cholesteatoma and examine current diagnosis and management strategies in detail.

scholarly journals The significance of the expression of cell proliferation and inflammation markers in the development of acquired middle ear cholesteatoma

2018 ◽  
Vol 75 (5) ◽  
pp. 487-495
Author(s):  
Milan Erdoglija ◽  
Ugljesa Grgurevic ◽  
Snezana Cerovic ◽  
Milena Jovic ◽  
Nenad Baletic ◽  
...  
Keyword(s):  
Middle Ear ◽  
External Auditory Canal ◽  
Clinical Picture ◽  
Clinical Characteristics ◽  
Biological Behavior ◽  
Ki 67 ◽  
Middle Ear Cholesteatoma ◽  
Significant Difference ◽  
Acquired Cholesteatoma ◽  
Cox 2

Background/Aim. Permanent proliferation and periodical infection are the main clinical characteristics of acquired middle ear cholesteatoma. The aim of this study was to research immunohistochemical characteristics of the skin along with the cholesteatoma process in the nearby tissue. This research should influence further studying of etiology and development of acquired middle ear cholesteatoma. Methods. We investigated clinical, histological and immunohistochemical characteristics of cholesteatoma in 50 samples from operated patients with acquired middle ear cholesteatomas. We classified all samples according to their clinical characteristics of cholesteatoma such as bone destruction, presence of infection or cholesteatoma extension and histological characteristics of cholesteatoma such as keratinisation, inflammatory process and extracellular matrix proliferation. We used mouse monoclonal antibodies for proliferating cell nuclear antigen (MAbs for PCNA), Ki-67, COX-2, CD 4 and CD 8 lymphocytes to investigate the expression of those characteristics in the cholesteatoma and in the control skin tissue. Statistical analyses were performed using SPSS for Windows version 16.0 (SPSS, Chicago, IL, USA). We used the independent group t-test, Spearman?s correlation analysis and Mann-Whitney U test to analyze statistical analysis. Results. Expression of PCNA, Ki-67, COX-2 and CD 8 lymphocytes in more serious clinical picture of cholesteatoma was almost equal as in less serious clinical picture of cholesteatoma. There was statistically significantly higher concentration of inflammation marker CD 4 lymphocytes, both in the acquired cholesteatoma and in the skin of bony portion of the external auditory canal near fibrocartilaginous annulus in more serious clinical picture of cholesteatoma than in less serious clinical picture of cholesteatoma (p < 0.01). There was statistically significant difference of expression of PCNA, Ki- 67, COX-2, CD 4 and CD 8 lymphocytes between all cholesteatoma samples and the skin of bony portion of the external auditory canal (p < 0.05) and statistically significant difference of expression of those markers between the skin of bony portion of the external auditory canal and retroauricular skin (p < 0.05). Conclusion. Inflammation of the skin of bony portion of the external auditory canal is a milestone in pathogenesis of acquired middle ear cholesteatoma. Expression of CD 4 lymphocytes can be the prognostic factor for acquired cholesteatoma clinical picture development. We found so much diversity in biological behavior through very different levels of cholesteatoma development. Expression of Ki-67 in acquired middle ear cholesteatoma is a reliable and stable marker of proliferation for acquired middle ear cholesteatoma.

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