The Possible Role of Sclerostin in the Pathogenesis of Tympanosclerosis

2021 ◽  
pp. 1-9
Author(s):  
Yu Huang ◽  
Xiansong Wang ◽  
Fashuai Wu ◽  
Yuqing Lu ◽  
Gengtian Liang ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Morphological Changes ◽  
Fibrous Tissue ◽  
Inflammatory Cells ◽  
Interstitial Tissue ◽  
Middle Ear Mucosa ◽  
Tissue Proliferation ◽  
Sclerotic Lesions ◽  
Experimental Group

<b><i>Objective:</i></b> The aim of this study was to investigate sclerostin (SOST) expression in a rat model of experimental tympanosclerosis (TS) and its possible role in the formation of TS. <b><i>Materials and Methods:</i></b> Thirty-four SD rats were randomly divided into 2 groups: experimental group (<i>n</i> = 17) and normal group (<i>n</i> = 17). The left tympanic cavities in the experimental group were inoculated with methicillin-resistant <i>Staphylococcus aureus</i>. The changes of tympanic membranes were examined and recorded under otoendoscope. Haematoxylin-eosin staining was adopted to detect the morphological changes in the tympanic membrane and middle ear mucosa. Immunohistochemistry and Western blot analysis were used to observe the expression of SOST, Wnt3a, β-catenin, and P-ERK1/2. <b><i>Results:</i></b> In the experimental group, sclerotic lesions were observed in 54.5% ears in the end of 6 weeks. Morphological changes such as mucosa incrassation, inflammatory cells infiltration, fibrous tissue proliferation, and interstitial tissue incrassation prominently appeared in the tympanic membrane and middle ear mucosa. SOST protein was mainly distributed in the cytoplasm of epithelial cells and gland cells, the expression of which increased significantly in the calcified experimental ears. In addition, expression levels of Wnt3a, β-catenin, and P-ERK1/2 increased significantly in the calcified group too. <b><i>Conclusion:</i></b> The upregulated expression level of SOST may be involved in the formation of TS, first, through the pro-phosphorylation of ERK1/2 in the inflammatory stage, and then through the enhancement of Wnt3a in the osteogenic stage.

Possible role of Dickkopf-1 protein in the pathogenesis of tympanosclerosis in a rat model

2017 ◽  
Vol 131 (10) ◽  
pp. 860-865
Author(s):  
Y Zhang ◽  
S Wang ◽  
Y Zheng ◽  
A Liu
Keyword(s):  
Middle Ear ◽  
Morphological Changes ◽  
Control Group ◽  
Sprague Dawley ◽  
Middle Ear Mucosa ◽  
Inflammatory Infiltration ◽  
Sprague Dawley Rats ◽  
Sclerotic Lesions ◽  
Tympanic Membranes

AbstractObjectives:This study aimed to investigate the expression of DKK1 protein in an experimental model of tympanosclerosis and its possible role in the pathogenesis of this disorder.Methods:Forty Sprague Dawley rats were included in the study: 20 in the control group (which received no treatment) and 20 in the experimental group (which received an incision to induce tympanosclerosis). Otomicroscopy was performed to observe the development of myringosclerosis. Haematoxylin and eosin staining was performed to observe the morphological changes. Western blot analysis and immunohistochemistry were performed to assess the expression of DKK1 protein.Results:At day 15, sclerotic lesions were observed in 70 per cent of the tympanic membranes. Inflammatory infiltration and hyaline degeneration markedly appeared in the tympanic membranes and middle-ear mucosa. DKK1 protein was mainly distributed in the cytoplasm of epithelial cells, which were widely distributed in the tympanic membranes and middle-ear mucosa. The expression of DKK1 protein was significantly decreased in the calcified experimental ears.Conclusion:DKK1 protein is involved in the pathogenesis of tympanosclerosis by regulating the Wnt/β-catenin signalling pathway.

Common drugs used in ENT

2009 ◽  
pp. 347-350
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Inner Ear ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Otitis Externa ◽  
Round Window ◽  
Acid Reflux ◽  
Tympanic Membrane Perforation ◽  
Active Infection ◽  
Middle Ear Mucosa ◽  
Membrane Perforation

Drugs used in the ear 348 Drugs used in the nose 349 Drugs used in the treatment of acid reflux 350 This group of drugs is widely used for the treatment of otitis externa. Otitis externa 2 drops tds for 10 days Presence of grommet or tympanic membrane perforation due to aminoglycoside ototoxicity in the inner ear. Risk thought to be low in the presence of active infection where the middle-ear mucosa is swollen and the antibiotic is unlikely to reach the inner ear via the round window...

Pathology of Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 24-26 ◽  
Author(s):  
Charles G. Wright ◽  
William L. Meyerhoff
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Mononuclear Cells ◽  
Bone Erosion ◽  
Morphological Changes ◽  
Chronic Phase ◽  
Tissue Destruction ◽  
Middle Ear Mucosa ◽  
Leukocytic Infiltration

Otitis media is characterized by inflammation of the middle ear. The pathologic changes seen in this condition tend to occur on a continuum, progressing from acute and subacute stages to the chronic phase, in which irreversible tissue damage is observed. The earliest morphological changes involve the lamina propria of the middle ear mucosa and include increased capillary permeability, edema, and leukocytic infiltration. During the late acute to subacute stages, the mucosa also tends to show a marked increase in numbers of ciliated and secretory epithelial cells. As the inflammatory process enters the chronic phase, there is a continuing shift in the population of infiltrating leukocytes toward increasing numbers of mononuclear cells that secrete substances that facilitate tissue destruction and fibrosis. There is also development and proliferation of granulation tissue, which is intimately involved in the process of bone erosion. As granulation tissue matures, it becomes denser and less vascular—a process that leads to permanent fibrosis and formation of adhesions that may significantly compromise middle ear function. Other pathologic entities occasionally associated with chronic otitis media include cholesteatoma, cholesterol cysts and granuloma, and tympanosclerosis, all of which may contribute to irreversible alterations of middle ear structure.

scholarly journals Acute Mastoiditis in Children: Susceptibility Factors and Management

2007 ◽  
Vol 7 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Slobodan Spremo ◽  
Biljana Udovčić
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Acute Mastoiditis ◽  
Middle Ear Mucosa ◽  
Susceptibility Factors ◽  
Intravenous Antibiotics ◽  
Intracranial Complications

The objective was to review our experience with clinical course, diagnostic and therapeutic profile of children treated for acute mastoiditis, and to investigate for possible susceptibility factors. Study was designed as retrospective review of pediatric patients presenting with acute mastoiditis secondary to acute otitis media over the last 6 years, from 2000 to 2006. The study involved children aged from 1 to 16 years treated for acute mastoiditis and subsequent intratemporal and intracranial complications in Clinic for otorhinolaryngology, Clinic Center Banja Luka. Selected clinical parameters, mastoid coalescence and risk factors for necessity of surgical intervention were analyzed. Medical history review of a total of 13 patients with acute mastoiditis was analyzed. Acute coalescent mastoiditis occurred 11 patients (84%) while noncoalescent form of acute mastoiditis occurred in 2 cases (16%). Intracranial complication occurred in 3 patients (2 meningitis and 1 peridural intracranial abscess), while 2 patients had intratemporal complication (subperiostal abscess) associated to coalescent mastoiditis. We observed clinical profile of acute mastoiditis in regard to pathology found on the tympanic membrane, middle ear mucosa and destructions on the bony wall of the middle ear and mastoid. The main signs of progressive infection were tympanic membrane perforation, pulsatile suppurative secretion from the mucosa, and intratemporal abscess. All patients with coalescent mastoiditis required mastoidectomy, while noncoalescent mastoiditis was treated conservatively with broad-spectrum intravenous antibiotics and myringotomy. In conclusion acute mastoiditis is uncommon but serious complication of acute otitis media in children associated with significant morbidity. Coalescent mastoiditis concomitant with subperiostal abscess, intracranial complications and mastoiditis not responsive after 48 hours to intravenous antibiotics should urge clinician to timely mastoid surgery.

Biochemical and Immunochemical Characteristics of Middle Ear Effusions in Relation to Bacteriological Findings

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 161-167 ◽  
Author(s):  
S. K. Juhn ◽  
John S. Huff ◽  
G. Scott Giebink ◽  
Elaine L. Mills
Keyword(s):  
Epithelial Cells ◽  
Otitis Media ◽  
Middle Ear ◽  
Pneumococcal Infection ◽  
Positive Culture ◽  
Middle Ear Mucosa ◽  
Tube Obstruction ◽  
Tissue Proliferation ◽  
Vascular Dilatation ◽  
Inflammatory Changes

Experimental otitis media was produced in chinchillas by eustachian tube obstruction or pneumococcal infection. Sequential changes in the histology of the middle ear mucosa and enzyme profile of the middle ear effusions (MEE) were studied. In serous otitis media (SOM) which followed tubal obstruction, the subepithelial space was widened by edema and capillary dilatation, and the middle ear space was filled with serous fluid. Slight hyperplasia of epithelial cells was also observed. The subepithelial space remained widened with mild fibrous change and capillary dilatation, and slight hyperplasia of epithelial cells persisted 42 days after obstruction. In purulent otitis media (POM), which followed inoculation of pneumococci into the middle ears, metaplasia of the epithelial layer from flat to columnar cells was observed. The subepithelial space was widened with loose fibrous connective tissue proliferation, vascular dilatation and inflammatory cell infiltration. Both lactate dehydrogenase (LDH) and lysozyme levels in MEE were higher in the POM group than in the SOM group. When bacterial enzymes, hyaluronidase and lipase activity were measured in MEE and plotted together with the percentage of positive culture of the MEE at different times after the experimental infection, the enzyme activities decreased with the clearing of bacteria and along with the resorption of inflammatory changes of middle ear mucosa evidenced by histology. In human MEE studies, immunoglobulins (IgG, IgA, IgM) of MEE were higher than in serum except IgM in serous MEE. The IgG content of MEE in the culture-negative group was higher than in the culture-positive group. Possible mechanisms for this difference were discussed.

scholarly journals Correlation between histomorphometric changes and the type of aerobic bacteria isolated in chronic suppurative otitis media

2011 ◽  
Vol 68 (1) ◽  
pp. 46-50
Author(s):  
Emilija Zivkovic-Marinkov ◽  
Milan Stankovic ◽  
Dragan Mihailovic ◽  
Mila Bojanovic
Keyword(s):  
Staphylococcus Aureus ◽  
Otitis Media ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Bacterial Flora ◽  
Inflammatory Cells ◽  
Chronic Suppurative Otitis Media ◽  
Aerobic Bacteria ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media

Background/Aim. Bacterial flora is a very important factor in pathogenesis of chronic suppurative otitis media (CSOM) and significantly influences the type and intensity of osteolytic process. There are few histomorphometric investigations of middle ear mucosa in chronic otitis. The aim of this study was to identify aerobic bacteria responsible for chronic suppurative otitis media as well as their association with histomorphometric changes of middle ear mucosa. Methods. A prospective study that comprised 153 patients treated in the Clinc for Ear, Thorat and Nose Diseases, Nis, was conducted. Bacteriologic analysis of diseased ear secretion was carried out in all patients. Intraoperatively removed granulation tissue was used for histomorphometry. The analysed parameters were: the number of inflammatory cells, as well as vascularization and vasodilatation. Results. The most frequently isolated aerobic bacteria from chronic suppurative otitis media were Staphylococcus aureus (29.02%), Pseudomonas aeruginosa (29.02%) and Proteus spp. (21.76%). There was no correlation between the type of pathologic process and the type of bacteria.The number of inflammatory cells in the granulation tissue in pure cultures of Staphylococcus aureus was 1,597.33 ? 549.45 and in Pseudomonas auriginosa cultures was 2,639 ? 648. Conclusion. This study showed that there is a statistically significant correlation between the number of inflammatory cells in the granulation tissue and the type of aerobic bacteria we isolated. The intensity of the infection in chronic suppurative otitis media depends on the type of the isolated bacteria, which emphasizes the importance of adequate preoperative antimicrobial therapy.

scholarly journals Epitympanic Diaphragm: Endoscopic Functional Tympanoplasty

2018 ◽  
Vol 01 (01) ◽  
pp. 023-028
Author(s):  
Sreerama Boddepalli ◽  
Rajesh Boddepalli
Keyword(s):  
Gas Exchange ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Normal Mucosa ◽  
Tympanic Membrane Perforation ◽  
Middle Ear Mucosa ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Middle Ear Cleft

Abstract Background Simple closure of tympanic membrane perforation is not a successful myringoplasty. It has to obey a lot of functional aspects of the middle ear cleft. Certain factors play a role in failure cases. The endoscopic functional myringoplasty or tympanoplasty is a clear visualization of all the parts of the middle ear; examination and removal of the disease from the hidden parts of the middle ear, examination of inter-attico-tympanic diaphragm; and removal of blocks, if any, in isthmus, to reestablish the gas exchange pathways and finally preserve the middle ear mucosa at maximum to further restore the ventilation. Methods Endoscopic tympanoplasty was performed in 100 patients with large tympanic membrane perforations and patent eustachian tube, using 4-mm “0” and “45” degree endoscopes by proper visualization of the tympanic diaphragm and isthmus in every patient and clearing its blockage if present. Results Among the 100 patients, 78 had epitympanic diaphragm blockage at the level of isthmus, 5 patients were found with closed tensor tympani folds, both vertical and horizontal without any ventilatory routes in them. Although in all the patients the eustachian tube was patent, we found majority of them had a dysventilation at the level of the epitympanic diaphragm. Thus, by performing endoscopic ventilatory pathway clearance and tympanoplasty, we achieved 94% positive results. Conclusion Epitympanic diaphragm is a functional barrier between upper and lower compartments of the middle ear cleft, which play important role in the ventilation and partial pressure regulation, blockage of its isthmus may lead to tympanic membrane retractions and perforations. With the aid of endoscopes of various degrees, removing any pathological blocks, recreating proper ventilation, reestablishing gas exchange mechanism, and maximum preservation of normal mucosa for the gas exchange are the aims of an endoscopic functional tympanoplasty procedure.

The conical cartilage of the cat's middle ear

1985 ◽  
Vol 99 (9) ◽  
pp. 831-838 ◽  
Author(s):  
Mahmoud A. Khalil ◽  
Myron Spector
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Round Window ◽  
Fibrous Tissue ◽  
Round Window Membrane ◽  
Chorda Tympani Nerve ◽  
Arch Bar ◽  
Extensive Calcification ◽  
Conical Structure ◽  
Round Window Niche

AbstractThe object of this study was to investigate the anatomy, histology, and possible function of a conical structure found in the middle ear of the cat. This conical structure lies across the dorso-caudal compartment of the middle ear. It is directly related to the course of the chorda tympani nerve in the middle ear. Its base is attached by fibrous tissue to the dorso-caudal segment of the tympanic bone adjacent to the tympanic membrane. Its apex rests on the promontory just rostral to the round window niche. Histologically, it is cartilaginous tissue enveloped by a mudous membrane with no trace of bone. Portions of some conical cartilage specimens display extensive calcification. A previous hypothesis suggests that this structure conducts high frequency sounds directly from the tympanic membrane to the round window membrane. This seems unlikely because its length is shorter than the distance between the tympanic membrane and round window membrane. The conical cartilage may be a vestigial remnant of the second arch bar (Reichert's cartilage).

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