Osteoclasts in Chronic Otitis Media, Cholesteatoma, and Otosclerosis

Bone resorption and remodeling are characteristic of chronic otitis media with and without cholesteatoma and otosclerosis. The consequences of this remodeling process may be hearing loss, repeated infection, vestibular disturbance, or intracranial complications. Evidence of osteoclastic bone resorption was found in surgical specimens of 11 of 24 cases of cholesteatoma, two of three cases of chronic otitis media, and three of ten cases of otosclerotic stapes; all three spongiotic lesions had osteoclasts. With careful serial sectioning these cells are almost always multinucleate and have the typical appearance of osteoclasts with ruffled borders. Some specimens had evidence of bone erosion in the absence of osteoclasts; this finding represents an inactive phase of the remodeling process. Since the osteoclast plays an important role in the resorption and remodeling of bone in these middle ear diseases, the source, physiology, and local control of these cells are of prime importance in investigating the pathophysiology of these diseases. At the present time, the local control of activation and recruitment of osteoclasts, as well as their chemotactic responses, is poorly understood.

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Serum sclerostın levels ın chronıc otıtıs medıa wıth and wıthout cholesteatoma

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.7.966 ◽

2020 ◽

Vol 66 (7) ◽

pp. 966-972

Author(s):

Elif Karali ◽

Ozgur Mehmet Yis

Keyword(s):

Bone Resorption ◽

Otitis Media ◽

Bone Erosion ◽

Chronic Otitis Media ◽

Study Groups ◽

Control Group ◽

Control Groups ◽

Vitamin D Levels ◽

Significant Difference ◽

Surgical Treatments

SUMMARY OBJECTIVE Sclerostin is a glycoprotein that plays a catabolic role in bone and is involved in the regulation of bone metabolism by increasing the osteoclastic bone resorption. In this study, serum sclerostin levels were measured in chronic otitis media (COM) with and without cholesteatoma, assuming that it might have a role in the aetiopathogenesis of bone resorption. METHODS A total of 44 patients with cholesteatomatous COM (cCOM) (n = 22) and non-cholesteatomatous COM (ncCOM) (n = 22) were included in this study, and 26 healthy volunteers without any chronic ear disease problem(s) constituted the control group (n = 26). RESULTS No significant difference was not found in terms of serum iPTH, ALP, and vitamin D levels between ncCOM, cCOM, and the control groups. A significant difference was found in terms of serum sclerostin, Ca, and P levels between ncCOM, cCOM, and the control groups (p<0.05). Serum sclerostin levels in the study groups were significantly higher but their serum Ca and P levels were significantly lower compared to the control group. CONCLUSION We think that serum sclerostin concentrations, which were significantly higher in patients with cCOM and ncCOM compared to healthy controls are associated with bone erosion. There is a need for further studies with larger samples in order to determine the relationship between sclerostin and bone erosion in cholesteatoma to help in establishing preventive measures against cholesteatoma and set new targets for the development of non-surgical treatments.

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Intracranial Complications of Chronic Otitis Media: Why Does It Still Occur?

Ear Nose & Throat Journal ◽

10.1177/0145561319840166 ◽

2019 ◽

Vol 98 (7) ◽

pp. 416-419

Author(s):

Hardip Singh Gendeh ◽

Asma binti Abdullah ◽

Bee See Goh ◽

Noor Dina Hashim

Keyword(s):

Otitis Media ◽

Access To Health Care ◽

Sinus Thrombosis ◽

Public Awareness ◽

Case Series ◽

Pneumococcal Vaccination ◽

Chronic Otitis Media ◽

Poor Access ◽

Intravenous Antibiotics ◽

Intracranial Complications

Intracranial complications secondary to chronic otitis media (COM) include otogenic brain abscess and sinus thrombosis. Intravenous antibiotics and imaging have significantly reduced the incidence of intracranial complications secondary to COM. However, the same does not apply to a developing country like Malaysia, which still experiences persisting otogenic complications. This case series describes 3 patients with COM and intracranial complications. All 3 patients had COM with mastoiditis, with 1 of the 3 having a cholesteatoma. Postulated reasons for the continued occurrence include poor access to health care, poor compliance with medication, and the lack of pneumococcal vaccination during childhood. In conclusion, public awareness and a timely specialty referral can reduce the incidence of intracranial complications of COM.

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The complications of chronic otitis media: report of 93 cases

The Journal of Laryngology & Otology ◽

10.1258/0022215001905012 ◽

2000 ◽

Vol 114 (2) ◽

pp. 97-100 ◽

Cited By ~ 105

Author(s):

Ustun Osma ◽

Sebahattin Cureoglu ◽

Salih Hosoglu

Keyword(s):

Brain Abscess ◽

Otitis Media ◽

Chronic Otitis Media ◽

Morbidity Rate ◽

Media Report ◽

Mortality And Morbidity ◽

Subperiosteal Abscess ◽

Intracranial Complications ◽

The Common ◽

Extracranial Complications

The aim of this study was to investigate the incidence, mortality and morbidity of complications due to chronic otitis media (COM). During the nine-year period 1990–1999, 2890 cases of COM were reviewed, 93 (3.22 per cent) having 57 (1.97 per cent) intracranial complications (IC) and 39 (1.35 per cent) extracranial complications (EC). In three patients more than one complication was observed. Meningitis and brain abscess were common in the IC group. Subperiosteal abscess (mastoid and Bezold’s abscess) was a common complication in the EC group. Cholesteatoma and granulation/polyp in the middle ear/mastoid were the major findings in both groups. Fifteen patients died from IC. Overall, the mortality rate was 16.1 per cent in all patients having complications, and in patients with IC it was 26.3 per cent. In all of the patients with complications, the morbidity rate was 11.8 per cent. Our study supports the finding that meningitis and brain abscess are the common complications of COM and the main reason for mortality.

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