Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF

Comparative immunohistochemical study of acquired cholesteatoma in children and adults

The Egyptian Journal of Otolaryngology volume 34, pages 116–121 (2018)Cite this article

Abstract

Objective

To compare the histopathological structure and immunohistochemical characteristics of acquired cholesteatoma in children and adults.

Patients and Methods

This study was carried out on 40 patients presenting with cholesteatomatous middle-ear disease. Twenty patients were of a pediatric age group (<18 years) and the rest were adults (>18 years). Patients were admitted to the ENT Department of Alexandria University Hospital. All cholesteatoma specimens were collected intraoperatively and preserved for histopathological examination and immunohistochemical technique using the epidermal growth factor (EGF) monoclonal antibody.

Results

Histopathological examination of the submitted specimens showed that strips of stratified squamous epithelium with the underlying tissues were fibrous in adults, whereas cellular inflammatory infiltrates were observed in children. The degree of fibrosis was significantly higher in the adult group, whereas the pediatric group had higher inflammatory infiltrate. Immunohistochemical examination indicated significantly higher expression of EGF in children compared with adults both in the matrix and in the perimatrix of acquired cholesteatoma.

Conclusion

Children with acquired cholesteatoma had higher inflammatory infiltration and significant expression of EGF in both the matrix and the perimatrix with less fibrosis compared with adults, explaining the possible pathogenesis of aggressive behavior of cholesteatoma in children.

References

  1. Meyerhoff WL, Kim CS, Paparella MM. Pathology of chronic otitis media. Ann Otol Rhinol Laryngol 1978; 87(Pt 1):749–760.

    Article  CAS  Google Scholar 

  2. Tos M. Incidence, etiology and pathogenesis of cholesteatoma in children. Adv Otorhinolaryngol 1988; 40:110–117.

    CAS  PubMed  Google Scholar 

  3. Lim DJ, Saunders WH. Acquired cholesteatoma: light and electron microscopic observations. Ann Otol Rhinol Laryngol 1972; 81:1–11.

    Article  CAS  Google Scholar 

  4. Tanaka Y, Kojima H, Miyazaki H, Koga T, Moriyama H. Roles of cytokines and cell cycle regulating substances in proliferation of cholesteatoma epithelium. Laryngoscope 1999; 109(Pt 1):1102–1107.

    Article  CAS  Google Scholar 

  5. Tanaka Y, Shiwa M, Kojima H, Miyazaki H, Kamide Y, Moriyama H. A study on epidermal proliferation ability in cholesteatoma. Laryngoscope, 1998; 108(Pt 1):537–542.

    Article  CAS  Google Scholar 

  6. Kojima H, Tanaka Y, Tanaka T, Miyazaki H, Shiwa M, Kamide Y, Moriyama H. Cell proliferation and apoptosis in human middle ear cholesteatoma. Arch Otolaryngol Head Neck Surg 1998; 124:261–264.

    Article  CAS  Google Scholar 

  7. Helgaland T, Engelen B, Olsnes C, Aarstad HJ, Vassbotn FS. In vitro cholesteatoma growth and secretion of cytokines. Acta Otolaryngol 2010; 130:815–819.

    Article  CAS  Google Scholar 

  8. Ma Y, Zhao H, Zhou X. Topical treatment with growth factors for tympanic membrane perforations: progress towards clinical application. Acta Otolaryngol 2002; 122:586–599.

    Article  CAS  Google Scholar 

  9. Nevoux J, Lenoir M, Roger G, Denoyelle F, Ducou Le Pointe H, Garabédian EN. Childhood cholesteatoma. Eur Ann Otorhinolaryngol Head Neck Dis 2010; 127:143–150.

    Article  CAS  Google Scholar 

  10. Roger G, et al. Predictive risk factors of residual cholesteatoma in children: a study of 256 cases. Am J Otol 1997; 18:550–558.

    CAS  PubMed  Google Scholar 

  11. Roger G, Denoyelle F, Chauvin P, Schlegel-Stuhl N, Garabedian EN. Aural acquired cholesteatoma in children: surgical findings, recurrence and functional results. Int J Pediatr Otorhinolaryngol 2006; 70:1269–1273.

    Article  Google Scholar 

  12. Quaranta A, Resta L, Santangelo A. Otomastoid cholesteatoma in children: histopathological findings. Int J Pediatr Otorhinolaryngol 1986; 12: 121–126.

    Article  CAS  Google Scholar 

  13. Bujia J, Holly A, Antolí-Candela F, Tapia MG, Kastenbauer E. Immunobiological peculiarities of cholesteatoma in children: quantification of epithelial proliferation by MIB1. Laryngoscope 1996; 106:865–868.

    Article  CAS  Google Scholar 

  14. Dornelles Cde C, da Costa SS, Meurer L, Rosito LP, da Silva AR, Alves SL. Comparison of acquired cholesteatoma between pediatric and adult patients. Eur Arch Otorhinolaryngol 2009; 266:1553–1561.

    Article  Google Scholar 

  15. Welkoborsky HJ, Jacob RS, Hinni ML. Comparative analysis of the epithelium stroma interaction of acquired middle ear cholesteatoma in children and adults. Eur Arch Otorhinolaryngol 2007; 264:841–848.

    Article  Google Scholar 

  16. Yetiser S, Satar B, Aydin N. Expression of epidermal growth factor, tumor necrosis factor-alpha, and interleukin-1alpha in chronic otitis media with or without cholesteatoma. Otol Neurotol 2002; 23: 845–849.

    Article  Google Scholar 

  17. Goto Y. Epidermal growth factor in cholesteatoma – the second report: the localization in the horny layer. Nihon Jibiinkoka Gakkai Kaiho 1990; 93: 1192–1199.

    Article  CAS  Google Scholar 

  18. Alves AL, Pereira CS, Carvalho Mde F, Fregnani JH, Ribeiro FQ. EGFR expression in acquired middle ear cholesteatoma in children and adults. Eur J Pediatr 2012; 171:307–310.

    Article  CAS  Google Scholar 

  19. Liu W, Yin T, Ren J, LiL, Xiao Z, Chen X, Xie D. Activation of the EGFR/Akt/ NF-kappaB/cyclin D1 survival signaling pathway in human cholesteatoma epithelium. Eur Arch Otorhinolaryngol 2014; 271:265–273.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Alexandria School of Medicine, University of Alexandria, Alexandria, Egypt

    Mohammed Bassiouny & Yasser Shewel MD

  2. Department of Histology, Alexandria School of Medicine, University of Alexandria, Alexandria, Egypt

    Nahed Badour

Authors
  1. Mohammed Bassiouny
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nahed Badour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasser Shewel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasser Shewel MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bassiouny, M., Badour, N. & Shewel, Y. Comparative immunohistochemical study of acquired cholesteatoma in children and adults. Egypt J Otolaryngol 34, 116–121 (2018). https://doi.org/10.4103/ejo.ejo_83_17

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejo.ejo_83_17

Keywords