Is There A Systemıc Inflammatory Effect of Cholesteatoma?

Abstract

Introduction Inflammation causes squamous epithelial transformation of the mucosa in the middle ear cavity and plays a role in the onset, growth, spread, and recurrence of cholesteatoma.

Objectives The objective of this study is to investigate the systemic inflammatory effect in chronic otitis with cholesteatoma.

Methods The study included a total of 311 patients comprising 156 patients with a pathology diagnosis of cholesteatoma and a control group of 155 with no active inflammation. The Neutrophil-to-lymphocyte Ratio (NLR) was calculated by dividing the neutrophil value by the lymphocyte value.

Results The mean NLR was 1.94 ± 0.91 in the patients with cholesteatoma and 1.94 ± 0.85 in the control group. We determined no statistically significant difference between the groups in respect of NLR (p = 0.983). We calculated the NLR as 2.01 ± 1.00 in patients with ossicle erosion and 1.82 ± 0.69 in those without ossicle erosion, 1.86 ± 0.85 in patients with bone erosion and 1.98 ± 0.95 in those without bone erosion. We determined no statistical difference between these values (p = 0.175).

Conclusion The results of this study showed that NLR had no predictive value in respect of bone erosions and associated complications in patients with cholesteatoma. The inflammatory effect of cholesteatoma is not systemic but remains more local.

Keywords

otitis media - cholesteatoma - inflammation

• References

• 1 Louw L. Acquired cholesteatoma pathogenesis: stepwise explanations. J Laryngol Otol 2010; 124 (6) 587-593
• 2 da Costa SS, Teixeira AR, Rosito LP. The contralateral ear in cholesteatoma. Eur Arch Otorhinolaryngol 2016; 273 (7) 1717-1721
• 3 Lee JH, Hong SM, Kim CW, Park YH, Baek SH. Attic cholesteatoma with tiny retraction of pars flaccida. Auris Nasus Larynx 2015; 42 (2) 107-112
• 4 Kuo CL. Etiopathogenesis of acquired cholesteatoma: prominent theories and recent advances in biomolecular research. Laryngoscope 2015; 125 (1) 234-240
• 5 Williams BA, Merhige ME. Association between neutrophil-lymphocyte ratio and impaired myocardial perfusion in patients with known or suspected coronary disease. Heart Lung 2013; 42 (6) 436-441
• 6 Bucak A, Ulu S, Oruc S , et al. Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy. Laryngoscope 2014; 124 (7) 1678-1681
• 7 Seretis C, Gourgiotis S, Gemenetzis G, Seretis F, Lagoudianakis E, Dimitrakopoulos G. The significance of neutrophil/lymphocyte ratio as a possible marker of underlying papillary microcarcinomas in thyroidal goiters: a pilot study. Am J Surg 2013; 205 (6) 691-696
• 8 Yenigun A, Karamanli H. Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome. J Laryngol Otol 2015; 129 (9) 887-892
• 9 Chole RA, Hughes RM, Faddis BTJ. Keratin particle-induced osteolysis: a mouse model of inflammatory bone remodeling related to cholesteatoma. J Assoc Res Otolaryngol 2001; 2 (1) 65-71
• 10 Ajalloueyan M. Experience with surgical management of cholesteatomas. Arch Otolaryngol Head Neck Surg 2006; 132 (9) 931-933
• 11 Kariya S, Okano M, Zhao P , et al. Activation of NLRP3 inflammasome in human middle ear cholesteatoma and chronic otitis media. Acta Otolaryngol 2016; 136 (2) 136-140
• 12 Louw L. Acquired cholesteatoma: summary of the cascade of molecular events. J Laryngol Otol 2013; 127 (6) 542-549
• 13 Li N, Qin ZB. Inflammation-induced miR-802 promotes cell proliferation in cholesteatoma. Biotechnol Lett 2014; 36 (9) 1753-1759
• 14 Si Y, Chen YB, Chen SJ , et al. TLR4 drives the pathogenesis of acquired cholesteatoma by promoting local inflammation and bone destruction. Sci Rep 2015; 5: 16683
• 15 Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. General pathology of infectious diseases. Philadelphia, PA: Elsevier; 2013: 309-326
• 16 Fang HY, Huang XY, Chien HT , et al. Refining the role of preoperative C-reactive protein by neutrophil/lymphocyte ratio in oral cavity squamous cell carcinoma. Laryngoscope 2013; 123 (11) 2690-2699
• 17 Kum RO, Ozcan M, Baklaci D , et al. Investigation of neutrophil-to-lymphocyte ratio and mean platelet volume in sudden hearing loss. Braz J Otorhinolaryngol 2015; 81 (6) 636-641
• 18 Wong BY, Stafford ND, Green VL, Greenman J. Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma. Head Neck 2016; 38 (Suppl. 01) E1903-E1908
• 19 Graziosi L, Marino E, De Angelis V, Rebonato A, Cavazzoni E, Donini A. Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer. Am J Surg 2015; 209 (2) 333-337