Aural cholesteatoma: role of tumor necrosis factor-alpha in bone destruction.
OBJECTIVE
The bone destruction in cholesteatoma is multifactorial. This study was undertaken to define the role of tumor necrosis factor-alpha (TNF-alpha) in bone destruction associated with cholesteatoma.


BACKGROUND
Tumor necrosis factor-alpha is an important inflammatory cytokine secreted by activated macrophages. It stimulates keratinocytes as an autocrine growth regulator. Few authors have localized TNF-alpha in aural cholesteatoma. An attempt was made in this study to show a correlation between TNF-alpha and cholesteatoma associated bone destruction by localizing TNF-alpha in cholesteatoma and measuring its serum level.


METHODS
Serum TNF-alpha levels were measured in 20 patients with cholesteatoma of temporal bone and histochemical staining was used to localize TNF-alpha in pathologic tissue excised at surgery.


RESULTS
Serum TNF-alpha levels in patients with cholesteatoma were significantly higher than in controls. In addition, TNF-alpha levels in patients with bone destruction were higher than in those without bone destruction. However, there was no correlation between age of the patient and serum TNF-alpha levels. The TNF-alpha was localized in various layers of cholesteatoma epithelium using indirect immunoperoxidase staining.


CONCLUSIONS
TNF-alpha is one of the cytokines produced by cholesteatoma that may be an important mediator of bone destruction associated with cholesteatoma. TNF-alpha has been localized in various layers of cholesteatoma and exerts a locally destructive effect on bone. Serum TNF-alpha levels are related to the extent of bone destruction.
Sastry
K V
KV
Department of Otolaryngology and Head & Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Sharma
S C
SC
Mann
S B
SB
Ganguly
N K
NK
Panda
N K
NK
D000293:Adolescent; D000328:Adult; D001862:Bone Resorption / Q000473:pathology*; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D004429:Ear Ossicles / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D014409:Tumor Necrosis Factor-alpha