Bone destruction in chronic otitis media is not mediated by the RANKL pathway or estrogen receptor-alpha

BACKGROUND

Chronic otitis media with or without cholesteatoma progresses with various degrees of bone resorption and remodeling. Estrogen mediates osteoprotective effects through the receptor activator of NF-κB ligand (RANKL) pathway, which is mainly mediated by estrogen receptor-alpha (ER-α).

OBJECTIVES

The present study investigated the expression patterns of receptor activator of NF-κB (RANK), osteoprotegerin (OPG), RANKL, and ER-α in pathological tissue from patients with chronic otitis media to determine the roles of those factors in osteolytic mechanisms underlying the pathogenesis of chronic otitis media.

METHODS

Normal and pathological specimens from 18 patients with chronic otitis media were examined.

RESULTS

There were no significant differences in RANK, OPG, RANKL, or ER-α mRNA expression between normal and pathological specimens of epithelial tissue.

CONCLUSIONS

Our findings suggested that RANK, OPG, RANKL, and ER-α are not associated with the bone destruction in chronic otitis media; other cytokines may directly activate the osteoclasts in chronic otitis media.

The Roles of Vascular Endothelial Growth Factor, Angiostatin, and Endostatin in Nasal Polyp Development

Background and Objectives: Microvascular remodeling and angiogenesis are elements of tissue remodeling characteristic of chronic inflammatory diseases, including nasal polyps (NPs). Angiogenesis reflects the balance between the actions of pro- and anti-angiogenic factors. Many pro-angiogenic factors are known, including vascular endothelial growth factor (VEGF). A number of anti-angiogenic factors (e.g., angiostatin and endostatin) also has been identified. Our objective was to assess the roles of VEGF, angiostatin, and endostatin in NP development.Methods: The expression levels of VEGF, angiostatin, and endostatin were measured in NPs harvested during endoscopic endonasal surgery and compared with those in inferior turbinate mucosa (control) samples acquired from patients with hypertrophic rhinitis without allergy. Western blotting and immunohistochemical staining were used to analyze all samples.Results: The levels of VEGF and angiostatin were significantly higher in the NP subjects than in the controls. Neither the VEGF/angiostatin ratio nor the endostatin level differed significantly between the two groups. However, the VEGF/endostatin ratio was significantly higher in the NP than in the control group. Both the NP and control tissues were diffusely immunoreactive for VEGF, angiostatin, and endostatin.Conclusion: NP-associated hypoxia can elevate angiostatin level; moreover, an imbalance in the VEGF/endostatin ratio can contribute to NP formation.

Congenital periauricular fistulas: possible variants of the preauricular sinus

OBJECTIVE

Although most preauricular sinuses are located near the anterior limb of the ascending helix, some are located in unusual areas around the auricle, as shown previously in limited reports. This study analyzed the clinical manifestations of congenital periauricular fistulas with unusual fistula locations and the possible relationship with the classical preauricular sinus.

METHODS

We reviewed the medical records of patients who underwent congenital periauricular sinus excision by three surgeons and followed them for more than 6 months. Clinical manifestations were compared between classical preauricular sinus (classical group) and congenital periauricular fistula (variant group) patients.

RESULTS

The classical and variant groups included 192 and 20 ears each, respectively. In the variant group, the fistula locations were in the ascending helix crus (15 ears, most common), infra-auricular area (3 ears), supra-auricular area (1 ear), and anterior to tragus (1 ear). In ears with fistulas in the ascending helix crus, the fistulous tract most often showed a medial direction (9 ears). There were 4 ears in the variant group with fistulous tracts running toward the postauricular area.

CONCLUSIONS

Congenital periauricular fistulas can be located anywhere around the auricle, and also considered the variant of preauricular sinus because the whole tracts were limited to lateral side of temporalis muscle and parotid gland as well as not associated with external auditory canal and facial nerve. Among them, the most common variant was a fistula on the ascending helix crus with short fistulous tract directed medially.