Bone Resorption in Chronic Otitis Media

1979 ◽  
Vol 88 (5) ◽  
pp. 693-700 ◽  
Author(s):  
Bruce J. Gantz ◽  
Jerry Maynard ◽  
Robert M. Bumsted ◽  
Cheng Chun Huang ◽  
Maxwell Abramson
Keyword(s):  
Acid Phosphatase ◽  
Bone Resorption ◽  
Otitis Media ◽  
Bone Cells ◽  
Chronic Otitis Media ◽  
Bone Destruction ◽  
Inflammatory Cells ◽  
Cellular Origin ◽  
Osteocyte Lacunae ◽  
Temporal Bones

Bone resorption is an important aspect of chronic otitis media contributing to many complications of this disease. It is postulated that the mechanism of this localized destructive process is chemical in origin. Collagenase, lysosomal enzymes, prostaglandins, and other cell mediators are thought to induce bone resorption, but the site of action and cellular origin of these substances remains unclear. In this report, we demonstrate the location and attempt to delineate the cellular origin of two enzymes, collagenase and the lysosomal enzyme acid phosphatase in guinea pig temporal bones and human ossicles from ears containing chronic otitis media. Tissue localization of these enzymes identifies sites of active bone resorption and demonstrates the cells initiating this process. Using immunohistochemical and immunocytochemical techniques, collagenase was seen surrounding mononuclear inflammatory cells of granulation tissue at bone resorbing margins and at the periphery of osteocyte lacunae adjacent to resorbing areas. Electron microscopic data suggests that collagenase is an extracellular enzyme found at the periphery of osteocytes. In addition, abundant acid phosphatase activity was seen in the same cells that exhibited collagenase staining, lending credence to the destructive function of these cells. The chronic inflammatory reaction found in chronic otitis media appears to activate bone destruction through the dynamic activity of mononuclear inflammatory cells and stimulates bone cells to increase their destructive biochemical functions.

S239 – Labyrinthine Changes in Otitis Media

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P155-P155
Author(s):  
Shruti Siddharth Joglekar ◽  
Armin Farajzadeh Deroee ◽  
Norimasa Morita ◽  
Sebahattin Cureoglu ◽  
Schachern Patricia ◽  
...  
Keyword(s):  
Inner Ear ◽  
Otitis Media ◽  
Stria Vascularis ◽  
Chronic Otitis Media ◽  
Inflammatory Cells ◽  
Spiral Ligament ◽  
Histopathologic Study ◽  
Significant Difference ◽  
Temporal Bones ◽  
Inflammatory Changes

Objectives Otitis media causes labyrinthine changes and subsequent sensorineural hearing loss. The aim of this histopathologic study was to evaluate the extension of inflammation to the inner ear and its effects. Methods Out of 614 temporal bones with otitis media, 47 (30 cases) with chronic and 35 (21 cases) with purulent were selected for histopathologic study. Subjects with a history of acoustic trauma, head trauma, ototoxic drugs and other otologic and systemic diseases affecting the inner ear were excluded. The pattern of labyrinthine inflammation was classified as localized purulent, localized serous, generalized seropurulent and generalized serous. Inner ear findings were compared to age-matched controls. Results 19% of temporal bones with chronic and 9% of temporal bones with purulent otitis media showed labyrinthine inflammatory changes. In chronic otitis media, inflammatory changes were: 56% localized purulent; 22% localized serous; 11% generalized seropurulent; and 11% generalized serous. Inflammatory changes in temporal bones with purulent otitis media included: 67% localized purulent; and 33% generalized seropurulent. Pathological findings included: serofibrinous precipitates and inflammatory cells in the scala tympani of basal turn and cochlear aqueduct; significant decrease in area of stria vascularis (p = 0.033); and loss of hair cells in the organs of Corti. No significant difference was found in area of spiral ligament area or number of fibrocytes in diseased and control bones. Conclusions Middle ear/inner ear interaction in otitis media can result in labyrinthine inflammation and cochlear damage. Early diagnosis and treatment of otitis media is important in preventing inner ear damage.

scholarly journals Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type

2017 ◽  
Vol 3 (3) ◽  
pp. 705 ◽  
Author(s):  
Yogeshwar Chandrashekar ◽  
Ravishankar Chandrashekar
Keyword(s):  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Inflammatory Cells ◽  
P Value ◽  
Hearing Improvement ◽  
Female Ratio ◽  
Fascia Graft ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688&gt;0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582&gt;0.05).</p><p><strong>Conclusions:</strong> The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. </p>

scholarly journals Radiographic imaging of mastoid in chronic otitis media: need or tradition?

2020 ◽  
Vol 6 (9) ◽  
pp. 1592
Author(s):  
Sabeeh Beig ◽  
Saifullah Khalid ◽  
Satish Chandra Sharma
Keyword(s):  
Otitis Media ◽  
Predictive Value ◽  
Plain Radiograph ◽  
Chronic Otitis Media ◽  
Bone Destruction ◽  
Limited Information ◽  
Radiological Findings ◽  
Plain Radiographs ◽  
Operative Findings ◽  
Mastoid Surgery

<p class="abstract"><strong>Background:</strong> Computed tomography is the imaging of choice in chronic otitis media (COM) but it is neither available at every centre nor is affordable to masses of economically weaker countries. In this situation where only X-ray facility is available should plain radiographs of mastoid be done ?. If yes then what is the analytical evidence? This study, was conducted to find the utility of plain radiographs of mastoid by comparing radiological findings vis-a-vis operative findings.</p><p class="abstract"><strong>Methods:</strong> Pre-operative radiographs of mastoids (Schuller’s view (s/v)) were taken and the radiological findings were statistically analysed with the operative findings.  </p><p class="abstract"><strong>Results:</strong> Plain radiograph of mastoid (s/v) predicted some of the surgical landmarks of mastoid surgery viz tegmen and sinus plates with a fair degree of accuracy. The positive predictive value (PPV) for radiolucent shadow (assumed to indicate bone destruction and thus cholesteatoma) was also high but at the same time, a low negative predictive value and a Cohen’s kappa test showing only a fair agreement underscores the point that absence of a radiolucent shadow does not rule out the presence of cholesteatoma.</p><p class="abstract"><strong>Conclusions:</strong> Radiographs of mastoid are helpful in providing a prior knowledge of the surgical landmarks in mastoid surgery. Hence with this information, if a surgeon finds himself more at ease in operating a patient then this imaging should be done when CT scan facility is unavailable. However, citing the limited information on other aspects of the disease, its use as a ‘routine’ investigation in chronic otitis media is discouraged.</p><p class="abstract"> </p>

scholarly journals Role for macrophage inflammatory protein (MIP)-1α and MIP-1β in the development of osteolytic lesions in multiple myeloma

Blood ◽  
2002 ◽  
Vol 100 (6) ◽  
pp. 2195-2202 ◽  
Author(s):  
Masahiro Abe ◽  
Kenji Hiura ◽  
Javier Wilde ◽  
Keiji Moriyama ◽  
Toshihiro Hashimoto ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Resorption ◽  
Stromal Cells ◽  
Neutralizing Antibodies ◽  
Bone Cells ◽  
Osteoclast Differentiation ◽  
Bone Destruction ◽  
Myeloma Cells ◽  
Inflammatory Protein ◽  
Macrophage Inflammatory Protein

Abstract Multiple myeloma (MM) cells cause devastating bone destruction by activating osteoclasts in the bone marrow milieu. However, the mechanism of enhanced bone resorption in patients with myeloma is poorly understood. In the present study, we investigated a role of C-C chemokines, macrophage inflammatory protein (MIP)–1α and MIP-1β, in MM cell-induced osteolysis. These chemokines were produced and secreted by a majority of MM cell lines as well as primary MM cells from patients. Secretion of MIP-1α and MIP-1β correlated well with the ability of myeloma cells to enhance osteoclastic bone resorption both in vitro and in vivo as well as in MM patients. In osteoclastogenic cultures of rabbit bone cells, cocultures with myeloma cells as well as addition of myeloma cell-conditioned media enhanced both formation of osteoclastlike cells and resorption pits to an extent comparable to the effect of recombinant MIP-1α and MIP-1β. Importantly, these effects were mostly reversed by neutralizing antibodies against MIP-1α and MIP-1β, or their cognate receptor, CCR5, suggesting critical roles of these chemokines. We also demonstrated that stromal cells express CCR5 and that recombinant MIP-1α and MIP-1β induce expression of receptor activator of nuclear factor-κB (RANK) ligand by stromal cells, thereby stimulating osteoclast differentiation of preosteoclastic cells. These results suggest that MIP-1α and MIP-1β may be major osteoclast-activating factors produced by MM cells.

Bone Resorption in Chronic Otitis Media the Role of Mast Cells

1985 ◽  
Vol 100 (1-2) ◽  
pp. 72-80 ◽  
Author(s):  
Gilead Berger ◽  
Michael Hawke ◽  
J. Kenneth Ekem
Keyword(s):  
Mast Cells ◽  
Bone Resorption ◽  
Otitis Media ◽  
Chronic Otitis Media

Bone Destruction Mechanisms in Chronic Otitis Media with Cholesteatoma: Specific Production by Cholesteatoma Tissue in Culture of Bone-Resorbing Activity Attributable to Interleukin-1 Alpha

1991 ◽  
Vol 100 (12) ◽  
pp. 989-998 ◽  
Author(s):  
Atsushi Kurihara ◽  
Ryo Yuasa ◽  
Masaru Toshima ◽  
Tomonori Takasaka
Keyword(s):  
Otitis Media ◽  
Calcium Release ◽  
Interleukin 1 ◽  
Chronic Otitis Media ◽  
Bone Destruction ◽  
Enzyme Linked Immunosorbent Assay ◽  
Pg E2 ◽  
Culture Supernatants ◽  
Bone Resorbing Activity

To clarify specific mechanisms underlying cholesteatoma-induced bone destruction, surgical specimens of middle ear inflammatory granulation tissue with or without cholesteatoma were maintained in vitro and the bone-resorbing activity in their culture supernatants was analyzed by means of calcium release from mouse calvaria. Almost the same levels of bone-resorbing activity and prostaglandin (PG) E2 were found in the supernatants of both types of tissue. By contrast, aural polyp tissue yielded hardly any such activity or PGE2. Under the influence of indomethacin, however, only tissue with cholesteatoma produced considerable bone resorption activity, whereas PGE2 production was suppressed completely. Such activity in the cholesteatoma culture supernatant was not due to contamination of endotoxin and proved to be blocked by the introduction of anti-interleukin (IL)-1α antibody into the calvarial assay system. Anti-IL-1β antibody had no effect on such activity. Interleukm-1α was detected only in cholesteatoma tissue culture supernatants by means of enzyme-linked immunosorbent assay and by bioassay. These data suggest that the bone destruction in otitis media with cholesteatoma may be attributed to IL-1α in addition to PGE2.

Pathology of Chronic Otitis Media

1978 ◽  
Vol 87 (6) ◽  
pp. 749-760 ◽  
Author(s):  
William L. Meyerhoff ◽  
Chong Sun Kim ◽  
Michael M. Paparella
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Granulation Tissue ◽  
Endolymphatic Hydrops ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Membrane Perforation ◽  
Bone Changes ◽  
Subdural Abscess ◽  
Temporal Bones

A review of 800 pathological temporal bones collected from autopsy cases revealed 333 (41.6%) to have some type of otitis media; purulent otitis media (52.5%), serous otitis media (6%), mucoid otitis media (4.5%), and chronic otitis media (36.9%). The 123 temporal bones with chronic otitis media were further studied and found to have granulation tissue, cholesteatoma, cholesterin granuloma, bone changes, and fibrosis. Other findings included tympanic membrane perforation, tympanosclerosis, metaplasia of the epithelium with subepithelial glandular formation, suppuration, labyrinthitis, and evidence of complications of chronic otitis media (meningitis, subdural abscess, brain abscess, petrositis, and endolymphatic hydrops). From this study it was concluded: 1) chronic otitis media occurred quite frequently, from a histological standpoint, in the absence of tympanic membrane perforation; 2) granulation tissue in temporal bones was found much more frequently in chronic otitis media than was cholesteatoma; and 3) complications and sequelae of otitis media tended to occur more commonly secondary to granulation tissue than to cholesteatoma.

scholarly journals Osteoclastogenesis in Periodontitis: Signaling Pathway, Synthetic and Natural Inhibitors

2018 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Ketherin Ketherin ◽  
Ferry Sandra
Keyword(s):  
Bone Resorption ◽  
Caffeic Acid ◽  
Bone Cells ◽  
Bone Destruction ◽  
Pharmacological Action ◽  
Therapeutic Agents ◽  
Specific Aspect ◽  
Bone Diseases ◽  
Chinese Herbs ◽  
Herbal Products

Osteoclast activities are responsible for the resorption of bone cells found in several bone diseases, one of which is periodontitis and arthritis. The downregulating signals of Receptor Activator of Nuclear Factor kB (RANK)-RANK Ligand and Tumor Necrosis Factor  (TNF)-a are the major cause of the bone destruction. Studies and experiments have been performed to overcome this matter. Various medications are now available to treat bone-related diseases, targeting the specific aspect of the signaling. Synthetic drugs such as denosumab and bisphosphonates have complex pharmacological action and have been the leading choice in treatment. Evidence in studies proved that natural resources including herbal products have potential application to therapy for bone loss, with caffeic acid and Caffeic Acid Phenethyl Ester (CAPE) showing significant inhibitory results and Chinese herbs such as Herba epimedii (Yín Yáng Huò) and Fructus psoraleae(Bǔ Gǔ Zhī) proved to contain components that give similar effects to estrogen. The purpose of this review is to discuss the therapy value of available synthetic and natural therapeutic agents. Understanding the mechanisms of both agents will not only clarify their function as therapeutic agents, but can also be the key to the treatment of diseases caused by bone resorption by targeting specific aspects of osteoclastogenesis.Keywords: osteoclastogenesis, TNF, RANKL, bone resorption, natural resource, signaling, treatment

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