Mediterr. J. Otol 2008; 4:(2)

Morphologic changes of middle ear mucosa in chronic otitis media with or without cholesteatoma

Sertac Yetiser,  Yusuf Hidir,   M. Salih Deveci

Gulhane Medical School, Dept of ORL & HNS, 06018 Etlik, Ankara, Turkey. yusufhidir@yahoo.com 

Objective: To investigate histopathologic differences between chronic otitis media (COM) with cholesteatoma and COM without cholesteatoma.

Materials and Methods: This retrospective study is an analysis of 74 middle ear biopsies from the promontory near the round window taken at first operation for COM performed. Thirty ears had COM with cholesteatoma. The other 44 ears had COM without cholesteatoma. Materials were stained by Hematoxylin-eosin and Toluidine blue. Density of gland and secretory cell, epithelial thickness, number of ciliated cell, infiltration and migration of chronic inflammatory cells (lymphocyte and plasma cell) and grade of vascular dilatation and proliferation between the patients with or without cholesteatoma were compared. The analysis of quantitative parameters was performed using Pearson c² test. 

Results: Infiltration and migration of lymphocyte and plasma cells, and grade of vascular dilatation and proliferation were significantly greater in ears without cholesteatoma than those with cholesteatoma.

Conclusions: These findings indicate that distinct physiopathologic mechanisms may play role in development of COM in terms of presence of cholesteatoma. Cholesteatoma may lead to destruction of vascular structures and chronic inflammatory cells by means of its pressure effect, numerous enzyme and cytokines.