[Devitalization of cholesteatoma on human ossicles by hydrostatic high pressure treatment].
BACKGROUND
In cholesteatoma surgery the use of autogenous ossicles for restoration of sound conduction is often limited because of ingrowth of matrix epithelia into the ossicular bone. In an attempt to eliminated these epithelial cells we tested extracorporal high-pressure hydrostatic treatment as a new method for devitalizing the bone but maintaining its structure.


METHODS
The inpact of different high hydrostatic pressures either on single cell suspensions of fibroblasts and osteoblasts, or on cells in ex-vivo ossicles chain was examined with different methods (quantitative proceedings, live/dead assay). Additional electron microscopic investigations illustrate the influence of high hydrostatic pressure treatment on cell suspensions of osteoblasts.


RESULTS
High hydrostatic pressure between 150 MPa and 250 MPa showed no effect to cellular material. A safe elimination of cell growth was found after an application of pressures at or above 400 MPa. The electron microscopic investigations illustrate clearly the destruction of cellular membranes after high hydrostatic pressure treatment.


CONCLUSIONS
These findings give hope that after extracorporal high hydrostatic pressure therapy autogenious ossicles might be used for middle ear recontructions even if they had contact with the cholesteatoma matrix or even were infitrated by keratinized squamous cell epithelia.
Dommerich
S
S
Universitätsklinikum Rostock, Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie "Otto Körner", Rostock. steffen.dommerich@med.uni-rostock.de
Pau
H-W
HW
Lindner
T
T
Just
T
T
Ostwald
J
J
D002455:Cell Division / Q000502:physiology; D002460:Cell Line; D002470:Cell Survival / Q000502:physiology; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery; D004429:Ear Ossicles / Q000473:pathology* / Q000601:surgery; D005347:Fibroblasts / Q000473:pathology; D006801:Humans; D006874:Hydrostatic Pressure; D066298:In Vitro Techniques; D008854:Microscopy, Electron; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D009998:Ossicular Prosthesis; D010006:Osteoblasts / Q000473:pathology; D010865:Pilot Projects