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- Open Access
Comparative immunohistochemical study of acquired cholesteatoma in children and adults
The Egyptian Journal of Otolaryngology volume 34, pages116–121(2018)
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.
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.
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.
Meyerhoff WL, Kim CS, Paparella MM. Pathology of chronic otitis media. Ann Otol Rhinol Laryngol 1978; 87(Pt 1):749–760.
Tos M. Incidence, etiology and pathogenesis of cholesteatoma in children. Adv Otorhinolaryngol 1988; 40:110–117.
Lim DJ, Saunders WH. Acquired cholesteatoma: light and electron microscopic observations. Ann Otol Rhinol Laryngol 1972; 81:1–11.
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.
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.
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.
Helgaland T, Engelen B, Olsnes C, Aarstad HJ, Vassbotn FS. In vitro cholesteatoma growth and secretion of cytokines. Acta Otolaryngol 2010; 130:815–819.
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.
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.
Roger G, et al. Predictive risk factors of residual cholesteatoma in children: a study of 256 cases. Am J Otol 1997; 18:550–558.
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.
Quaranta A, Resta L, Santangelo A. Otomastoid cholesteatoma in children: histopathological findings. Int J Pediatr Otorhinolaryngol 1986; 12: 121–126.
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.
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.
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.
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.
Goto Y. Epidermal growth factor in cholesteatoma – the second report: the localization in the horny layer. Nihon Jibiinkoka Gakkai Kaiho 1990; 93: 1192–1199.
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.
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.
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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
- epidermal growth factor