Cholesteatoma prevention by local treatment with vitamin A.
OBJECTIVE
In view of the proven effectiveness of vitamin A for the treatment of hyperkeratosis, it was hypothesized that vitamin A may also be a feasible therapeutic option for cholesteatoma, which has similar histologic features.


BACKGROUND
Cholesteatoma is a major cause of chronic ear disease, often requiring surgery. The recurrence rate may exceed 20%. Hyperkeratosis is a major sequela of tympanomastoid surgery, causing chronic ear hygiene problems.


METHODS
The external auditory canals of 40 Mongolian gerbils were ligated to induce cholesteatomas. The ears were divided into three groups by type of treatment: group I, vitamin A drops (n = 40); group II, Cortisporin drops (n = 20); group III, no treatment (control subjects) (n = 20). Examination for the development and grade of cholesteatomas was performed after 9 months.


RESULTS
Cholesteatomas developed in 26 ears (65%) of group I, 12 ears (60%) of group II, and 20 ears (100%) of group III. The differences were significant between groups I and III and groups II and III for both rate of cholesteatomas and severity of grade. There were no significant differences between groups I and II.


CONCLUSIONS
Local treatment reduces the risk of cholesteatomas in ligated gerbilline ears. Cortisporin and vitamin A are equally effective as local treatments.
Nageris
B I
BI
Department of Otolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Grushko
I
I
Feinmesser
R
R
D000818:Animals; D018424:Cholesteatoma, Middle Ear / Q000517:prevention & control* / Q000601:surgery*; D004338:Drug Combinations; D005849:Gerbillinae; D006854:Hydrocortisone / Q000627:therapeutic use; D009355:Neomycin / Q000627:therapeutic use; D011112:Polymyxin B / Q000627:therapeutic use; D011184:Postoperative Period; D014801:Vitamin A / Q000627:therapeutic use*
D004338:Drug Combinations; C033225:hydrocortisone, neomycin, polymyxin B drug combination; D014801:Vitamin A; D009355:Neomycin; D011112:Polymyxin B; D006854:Hydrocortisone