Histology, Pathogenesis, and Treatment of Cholesteatoma

1984 ◽  
Vol 93 (4_suppl) ◽  
pp. 125-128 ◽  
Author(s):  
Maxwell Abramson ◽  
Hiroshi Moriyama ◽  
Cheng Chun Huang
Keyword(s):  
Animal Model ◽  
Bone Resorption ◽  
Connective Tissue ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Increase Bone Resorption ◽  
Pathogenic Factors ◽  
Middle Ear Cholesteatoma

Factors present in cholesteatoma connective tissue induce bone resorption in chronic otitis media. The presence of skin and its products appears to exacerbate the destructive influence of connective tissue. One exacerbating factor is pressure, shown in an animal model to increase bone resorption by influencing the subepithelial connective tissue. Consideration of pathogenic factors provides a rationale for modifications in the treatment of middle ear cholesteatoma.

scholarly journals Clinical analysis on surgery of middle ear cholesteatoma and chronic otitis media

2016 ◽  
Vol 130 (S3) ◽  
pp. S221-S221
Author(s):  
Ayiheng Qukuerhan ◽  
Nilipaer Alimu ◽  
Halimulati Muertiza ◽  
Pilidong Kuyaxi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Clinical Analysis ◽  
Middle Ear Cholesteatoma

Prostaglandins and Otitis Media: Studies in the Chinchilla

1980 ◽  
Vol 88 (3) ◽  
pp. 316-323 ◽  
Author(s):  
Timothy T.K. Jung ◽  
Douglas M. Smith ◽  
S.K. Juhn ◽  
Jonathan M. Gerrard
Keyword(s):  
Bone Resorption ◽  
Otitis Media ◽  
Middle Ear ◽  
Unsaturated Fatty Acids ◽  
Chronic Otitis Media ◽  
Active Role ◽  
Middle Ear Mucosa ◽  
Naturally Occurring ◽  
Wide Range ◽  
Human Middle Ear

Prostaglandins (PG) are naturally occurring, cyclic, unsaturated fatty acids that possess a wide range of potent biologic activities. Prostaglandins have been found in human middle ear effusions and may have implications for understanding the inflammation and, possibly, the bone resorption seen in chronic otitis media. In the study presented, PGs were measured by radioimmuno-assay in middle ear effusions from experimentally induced serous and purulent otitis media in chinchillas. The ability of chinchilla middle ear mucosa to synthesize PGs from 14C-arachidonic acid was also demonstrated. The authors suggest an active role for PGs in the inflammation and the bone resorption seen in otitis media.

scholarly journals Role of N-acetyl-beta-d-hexosaminidase in cholesteatoma tissue.

2007 ◽  
Vol 54 (2) ◽  
pp. 365-370 ◽  
Author(s):  
Ewa Olszewska ◽  
Slawomir Olszewski ◽  
Malgorzata Borzym-Kluczyk ◽  
Krzysztof Zwierz
Keyword(s):  
Bone Resorption ◽  
Connective Tissue ◽  
Temporal Bone ◽  
Middle Ear ◽  
Inflammatory Reaction ◽  
Squamous Epithelium ◽  
Normal Skin ◽  
Chronic Otitis Media ◽  
Chronic Inflammatory Reaction

Cholesteatoma is a destructive disease characterized by the progressive expansion of keratinizing squamous epithelium in the middle ear and mastoid, and chronic inflammatory reaction of the subepithelial connective tissue. N-Acetyl-beta-d-hexosaminidase (HEX) catalyzes the release of terminal non-reducing N-acetyl-d-hexosamine residues acting on glucosides and galactosides in glycoproteins, G(M2)-gangliosides and glycosaminoglycans (GAGs). In this study the activities of HEX were measured in cholesteatoma tissue and in normal skin to demonstrate a possible role of HEX in bone resorption in the area adjacent to cholesteatoma. Cholesteatomas (n = 21) and normal adult retroauricular skin (controls, n = 21), were collected from patients during surgery due to chronic otitis media. In 20 of 21 specimens a significantly higher activity of HEX was observed in cholesteatoma tissue compared with that in normal skin. Mean release of HEX from the activated cells was 68.55 +/- 30.77 nkat/g wet tissue in cholesteatoma and 31.79 +/- 10.02 nkat/g wet tissue in skin specimens. It may explain the process of bone resorption in the area adjacent to cholesteatoma, i.e. ossicles or temporal bone. This study suggests that drugs inhibiting HEX activity, such as iminocyclitols, may be useful in cholesteatoma treatment.

scholarly journals Bacterial diversity of chronic middle ear lesions revealed by high-throughput sequencing

2021 ◽  
Author(s):  
Xingzhi Gu ◽  
Xiuqing Cheng ◽  
Tuoheti Abulajiang ◽  
Xiaoban Huang
Keyword(s):  
Bacterial Diversity ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
16S Rrna Genes ◽  
Rrna Genes ◽  
Epithelial Tissue ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Middle Ear Cholesteatoma

AbstractChronic otitis media is a common middle ear disease in otolaryngology and head and neck surgery. Bacterial infection is considered the main cause of disease, but relying on conventional bacterial cultures can be problematic for identification of specific pathogens. Current research suggests that bacteria in microbial communities can only be identified by rDNA sequencing of bacteria.This prospective study utilized broad-range PCR amplification of 16S rRNA genes with clone analysis to compare bacterial diversity in lesions from 6 patients with chronic suppurative otitis media (CSOM) and 10 patients with cholesteatoma of middle ear lesions. Bacteria were analyzed at the phylum, order, family, genus, and species levels. Bacterial species abundance and species diversity were greater in cholesteatoma of the middle ear lesions than in CSOM lesions. At all bacterial taxonomic levels, the epithelial tissue of middle ear cholesteatoma was complex in terms of bacterial diversity, covering a large number of Gram-positive and Gram-negative bacteria, likely related to bacterial microbiome formation. In contrast, bacteriology of the CSOM lesions was relatively simple at all taxonomic levels, with all sequences characterized as belonging to Gram-negative bacteria. These results suggest that persistent infection of middle ear cholesteatoma may be a microbial flora disorder, which is related to conditional pathogenic bacteria, rather than a single bacterial infectious disease. Findings from the study may have implications in the selection of antimicrobial agents for the treatment of chronic otitis media.

Activation of NLRP3 inflammasome in human middle ear cholesteatoma and chronic otitis media

2015 ◽  
Vol 136 (2) ◽  
pp. 136-140 ◽  
Author(s):  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Pengfei Zhao ◽  
Yuko Kataoka ◽  
Junko Yoshinobu ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Nlrp3 Inflammasome ◽  
Chronic Otitis Media ◽  
Middle Ear Cholesteatoma ◽  
Human Middle Ear

scholarly journals Expression of matrix metalloproteinase-9 in acquired middle ear cholesteatoma

2020 ◽  
Vol 11 (1) ◽  
pp. 29-36
Author(s):  
Dalibor Vranješ ◽  
Slobodan Spremo ◽  
Siniša Šolaja
Keyword(s):  
Matrix Metalloproteinase ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Matrix Metalloproteinase 9 ◽  
Expression Levels ◽  
Positive Expression ◽  
Middle Ear Cholesteatoma ◽  
Acquired Cholesteatoma ◽  
Metalloproteinase 9

Introduction. Matrix metalloproteinase-9 (MMP-9) plays one of the key roles in the migration of inflammatory cells and the destructive behavior of acquired middle ear cholesteatoma. The aim of the study was to determine the expression levels of MMP-9 in chronic otitis media, with and without acquired cholesteatoma, as well as to determine the correlation between them and the pathomorphological changes in the tympanic membrane (TM). Methods. Immunohistochemical study included 178 patients of both sexes, aged 5-75 years, who underwent microsurgical treatment of chronic otitis media (COM) at the Ear, Nose and Throat Department of the University Clinical Center of the Republic of Srpska in Banja Luka from 2015 to 2018. Patients were divided into two groups on the basis of the presence or absence of acquired cholesteatoma: 97 (CCOM) and 81 (COMWC). The samples of the perimatrix of acquired cholesteatoma (n=97) and inflamed middle ear mucosa (n=81) were taken intraoperatively. The presence of retraction and certain types and subtypes of TM perforations were examined by intraoperative exploration. MMP-9 expression levels were determined by immunohistochemical analysis. Results. In the presence of cholesteatoma and highly positive expression of MMP-9, the marginal type of TM perforation was more likely to occur (p<0.01) while in negative expression of MMP-9 in the COMWC group, the central type was more likely to occur (p<0.01). There was a higher probability of the presence of attic subtype of TM perforation in patients with cholesteatoma and moderate positive expression of MMP-9 (p<0.01). There was not a statistically significant contribution of any of the factors in the prediction of the influence on the occurrence of TM retraction. Conclusion. The presence of acquired middle ear cholesteatoma and highly positive expression of MMP-9 are statistically significant predictors of the presence of marginal type and attic subtype of TM perforation. Expression levels of MMP-9 may have potential clinical significance in the development of irreversible pathomorphological changes on TM in middle ear cholesteatoma.

Clinical Characteristics and Surgical Benefits and Problems of Chronic Otitis Media and Middle Ear Cholesteatoma in Elderly Patients Older Than 70 Years

2012 ◽  
Vol 33 (7) ◽  
pp. 1213-1217 ◽  
Author(s):  
Akihiro Shinnabe ◽  
Mariko Hara ◽  
Masayo Hasegawa ◽  
Shingo Matsuzawa ◽  
Hiromi Kanazawa ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Otitis Media ◽  
Middle Ear ◽  
Clinical Characteristics ◽  
Chronic Otitis Media ◽  
Middle Ear Cholesteatoma

Differential Osteoclast Activation in Endochondral and Intramembranous Bone

1993 ◽  
Vol 102 (8) ◽  
pp. 616-619 ◽  
Author(s):  
Richard A. Chole
Keyword(s):  
Hearing Loss ◽  
Bone Resorption ◽  
Osteogenesis Imperfecta ◽  
Temporal Bone ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Intramembranous Bone ◽  
Inner Surface ◽  
Osteoclast Activation

Osteoclast activation within the temporal bone leads to hearing loss in a variety of pathologic conditions, including otosclerosis, osteogenesis imperfecta, Paget's disease of bone, and chronic otitis media. Although endochondral (EC) bone is remodeled in these diseases, it is relatively more resistant to remodeling when compared to intramembranous (IM) bone. In this study, localized bone resorption and remodeling were induced on the inner surface of the middle ear by pressurization with air to 10 mm Hg above atmospheric. Osteoclast surface increased in IM bone, but not in EC bone. This study supports the concept that there may be fundamental differences between EC and IM bone and that EC is more resistant to pressure-induced localized resorption than IM bone.

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

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