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Zhang C, Liu YW, Chen M, Min S, Mao J, Li Q, Chi Z. CoCl 2 -simulated hypoxia potentiates the osteogenic differentiation of fibroblasts derived from tympanosclerosis by upregulating the expression of BMP-2. Cell Biol Int 2022; 46:1423-1432. [PMID: 35811437 DOI: 10.1002/cbin.11845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/20/2022] [Accepted: 03/15/2022] [Indexed: 11/08/2022]
Abstract
Tympanosclerosis (TS) is a result of long-standing middle ear inflammation characterized by fibroblasts ossification. Fibrosis is the last revertible stage in the progress of middle ear inflammation to TS. It was hypothesized that chronic hypoxia could be modulating fibrosis, which in turn additionally further aggravated hypoxia via decreasing oxygen diffusion. However, the effects of hypoxia on osteoinductive activity of fibroblasts have not been explored. Herein, we purposed to explore the role of hypoxia in osteogenic differentiation of fibroblasts derived from TS. The expression of bone morphogenetic protein-2 (BMP-2), hypoxia-inducible factor-1α (HIF-1α), and Vimentin in the human surgical specimens of tympansclerosis was investigated by immunofluorescent staining. Furthermore, cultured fibroblasts were stratified into the following study groups: control, 25, 50, and 100 μM cobaltous chloride (CoCl2 ) group. BMP-2, as well as HIF-1α levels of expression were detected via western blotting and immunofluorescence analysis. We found that the expression of BMP-2 and HIF-1α was significantly upregulated in TS tissues and these fibroblasts, which was vimentin positive surrounding sclerotic plaques, were also expressing HIF-1α positive. The results also demonstrated that CoCl2 treatment increased nuclear HIF-1α protein level in the fibroblast. Furthermore, treatment with CoCl2 significantly increased BMP-2 expression and remarkably elevated alkaline phosphatse activity and the mineralized nodules area. These data illustrate that hypoxia may play an osteogenic role in TS fibroblasts via the elevated expression of a possible osteogenic factor, BMP-2.
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Affiliation(s)
- Chen Zhang
- ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yang-Wenyi Liu
- ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, PR China
| | - Min Chen
- ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, PR China
| | - Shiyao Min
- ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, PR China
| | - Jiabao Mao
- ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, PR China
| | - Qin Li
- Stomatology Department, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Zhangcai Chi
- ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, PR China
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Akkoca Ö, Kargın Kaytez S, Yumuşak N, Bilgen AS, Kavuzlu A, Öcal R, Çelik H, Arslan N. The Effect of Curcumin on the Prevention of Myringosclerosis in Rats. Turk Arch Otorhinolaryngol 2021; 59:26-32. [PMID: 33912858 PMCID: PMC8054924 DOI: 10.4274/tao.2020.5827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/14/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the preventative effect of oral curcumin (CMN) on myringosclerosis (MS) in an experimental rat model. METHODS The study included 21 female Wistar albino rats randomly separated into three groups. Group 1 was given no treatment (control group). In Group 2 and Group 3, the tympanic membrane (TM) was perforated using a sterile ear pick. The rats in Group 3 were administered oral CMN 200 mg/kg/day. All rats were sacrificed after 16 days. Otomicroscopic and histopathologic examinations were performed on the tympanic membranes. RESULTS Histopathologic examinations revealed that there were statistically significant differences between Group 2 and Group 3 in terms of MS degrees (p<0.001) and mean thicknesses of TMs (p<0.001), but there were no differences between Group 1 and Group 3. In respect of MS detected by otomicroscopy, a statistically significant difference was determined between Groups 1 and 2 (p<0.001) and between Groups 2 and 3 (p<0.01), but there was no significant difference between Group 1 and Group 3 (p=0.575). CONCLUSION Orally administered CMN can prevent myringosclerosis formation in experimentally induced myringotomies.
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Affiliation(s)
- Özlem Akkoca
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Selda Kargın Kaytez
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Nihat Yumuşak
- Department of Pathology, Harran University Faculty of Veterinary Medicine, Şanlıurfa, Turkey
| | - Akif Sinan Bilgen
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Ali Kavuzlu
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Ramazan Öcal
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Hatice Çelik
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Necmi Arslan
- Department of Otorhinolaryngology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
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Dong Z, Zhou M, Ye G, Ye J, Xiao M. Development and Validation of a Clinical Score for Predicting the Risk of Tympanosclerosis Before Surgery. EAR, NOSE & THROAT JOURNAL 2020; 101:NP169-NP177. [PMID: 32894702 DOI: 10.1177/0145561320951676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To develop and validate a clinical score to predict the risk of tympanosclerosis before surgery. METHODS A sample of 404 patients who underwent middle ear microsurgery for otitis media was enrolled. These patients were randomly divided into 2 cohorts: the training cohort (n = 243, 60%) and the validation cohort (n = 161, 40%). The preoperative predictors of tympanosclerosis were determined by multivariate logistic regression analysis and implemented using a clinical score tool. The predictive accuracy and discriminative ability of the clinical score were determined by the area under the curve (AUC) and the calibration curve. RESULTS The multivariate analysis in the training cohort (n = 243, 60%) identified independent factors for tympanosclerosis as the female sex (odds ratio [OR]: 3.83; 95% CI: 1.66-9.37), the frequency-specific air-bone gap at 250 Hz ≥ 45 dB HL (OR: 3.68; 95% CI: 1.68-8.57), aditus ad antrum blockage (OR: 3.29; 95% CI: 1.38-8.43), type I eardrum calcification (OR: 25.37; 95% CI: 8.41-88.91) or type II eardrum calcification (OR: 18.86; 95% CI: 6.89-58.77), and a history of otitis media ≥ 10 years (OR: 4.10; 95% CI: 1.58-11.83), which were all included in the clinical score tool. The AUC of the clinical score for predicting tympanosclerosis was 0.89 (95% CI: 0.85-0.93) in the training cohort and 0.89 (95% CI: 0.84-0.95) in the validation cohort. The calibration curve also showed good agreement between the predicted and observed probability. CONCLUSIONS The clinical score achieved an optimal prediction of tympanosclerosis before surgery. The presence of calcification pearls on the promontorium tympani is a strong predictor of tympanosclerosis with stapes fixation.
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Affiliation(s)
- Zhihuai Dong
- Department of Otolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, 56660Medical College of Zhejiang University, Hangzhou, China
| | - Mingguang Zhou
- Department of Otolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, 56660Medical College of Zhejiang University, Hangzhou, China
| | - Gaofei Ye
- Department of Otolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, 56660Medical College of Zhejiang University, Hangzhou, China
| | - Jing Ye
- Department of Otolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, 56660Medical College of Zhejiang University, Hangzhou, China
| | - Mang Xiao
- Department of Otolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, 56660Medical College of Zhejiang University, Hangzhou, China
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Kim EH, Park KW, Lee SH, Kim BJ, Park YH. Analysis of Risk Factors for Myringosclerosis Formation after Ventilation Tube Insertion. J Korean Med Sci 2020; 35:e83. [PMID: 32242343 PMCID: PMC7131898 DOI: 10.3346/jkms.2020.35.e83] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/30/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI). METHODS A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS-. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed. RESULTS Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS- group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI. CONCLUSION Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI.
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Affiliation(s)
- Eung Hyub Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Ki Wan Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Seung Hun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Bong Jik Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea.
| | - Yong Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea.
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Does calcemia influence the onset of myringosclerosis after myringotomy with the insertion of ventilation tubes? ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017. [DOI: 10.1016/j.otoeng.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Branco C, Paço J. Does calcemia influence the onset of myringosclerosis after myringotomy with the insertion of ventilation tubes? ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 68:323-327. [PMID: 28522133 DOI: 10.1016/j.otorri.2017.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/10/2017] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Myringosclerosis is one of the most frequent late complications of the insertion of ventilation tubes, and its aetiopathogenesis remains unknown. The calcification that occurs in the formation of myringosclerosis plaque raises the hypothesis of the presence of a calcium metabolism disorder. The objective is to determine whether calcemia contributes to the development of myringoscelerosis after insertion of ventilation tubes. MATERIAL AND METHODS A longitudinal, prospective, analytical cohort study was conducted in patients undergoing myringotomy with the insertion of ventilation tubes due to otitis media with effusion. Calcemia was evaluated pre-operatively and in the follow-up the appearance of myringosclerosis and the percentage of the tympanum involved were evaluated. RESULTS The study included 156 patients (297 ears), with calcemia values ranging from 7.6 to 10.2mg/dl. Myringosclerosis was identified in 35.4% of the operated ears. No relationship was found between the appearance of myringosclerosis and calcemia (p=.596). It was found, however, that the greater the percentage of the tympanum affected by myringosclerosis, the lower the calcemia values (p=.014). CONCLUSION The population studied had calcemia values within the normal range, which allows us to infer that no changes in calcium metabolism are required for the development of myringosclerosis. Moreover, unlike in previous studies, higher calcium levels are not associated with more myringosclerosis. Calcemia did not influence the appearance of myringosclerosis after myringotomy with the insertion of ventilation tubes.
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Affiliation(s)
- Carla Branco
- ENT Department, Hospital de Vila Franca de Xira, Lisboa, Portugal.
| | - João Paço
- ENT Department, Hospital CUF Infante Santo, Lisboa, Portugal
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Tympanosclerosis Presenting as Mass: Workup and Differential. Case Rep Otolaryngol 2016; 2016:9821493. [PMID: 27656306 PMCID: PMC5021455 DOI: 10.1155/2016/9821493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/05/2016] [Accepted: 08/16/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction. Tympanosclerosis is a commonly encountered entity within ENT clinics and primary care settings. Recognizing ear pathology is essential for correct management. Oftentimes the diagnosis is clear; however in certain cases further workup to rule out other more insidious disease processes is warranted. Case Report. We present a case of tympanosclerosis which presented as an ear mass without classic appearance of tympanosclerosis. Through imaging and biopsy the diagnosis of tympanosclerosis was made. The patient was treated surgically with good outcome. Discussion. Various ear pathologies, with different treatment algorithms, may present as clinically similar to one another. Differential diagnosis for this case included tympanosclerosis, cholesteatoma, or other middle ear masses. We review these entities and discuss their pathophysiology and implications on management.
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Berdich K, Gentil F, Parente M, Garbe C, Santos C, Paço J, Natal Jorge R, Martins P, Faur N. Finite element analysis of the transfer of sound in the myringosclerotic ear. Comput Methods Biomech Biomed Engin 2015; 19:248-256. [DOI: 10.1080/10255842.2015.1010526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lee CH, Yoo CK, Hong JE, Kim HJ, Lim DG, Kim KJ. Resolved effusion on myringotomy: a study of dry tap without general anesthesia. Int J Pediatr Otorhinolaryngol 2011; 75:635-8. [PMID: 21362577 DOI: 10.1016/j.ijporl.2011.01.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 01/28/2011] [Accepted: 01/29/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Finding a resolution of middle ear effusion using myringotomy, or dry tap (DT), is relatively common, but its clinical outcome is confounded by general anesthesia (GA). The confounding effect of GA and a time delay can be removed because laser myringotomy can be completed under topical anesthesia, which is a routine procedure for otitis media with effusion (OME) before GA in our clinic. DT without GA would clarify the clinical outcome, and the percentage of recurrence for OME after DT would be clinically relevant. The objectives of the present study are (1) to clarify the clinical nature of DT without including the confounding effect of GA and a time delay and (2) to determine if OME recurs when a ventilation tube (VT) is not used for DT. METHODS The control group consisted of 308 children who received an unilateral myringotomy due to a natural resolution in the contralateral ear. The experimental group consisted of 296 children who had a bilateral myringotomy, and a ventilation tube was not inserted for DTs after laser myringotomy under topical anesthesia. The rate of DT and the recurrence rate of OME without tube insertion was the main outcome measure. RESULTS In the control group, which showed a natural resolution, the rate of DT was 16.9% (52/308) of patients, and DT was more common in non-B tympanometry, which only had a recurrence rate of 17.3% (9/52). In the study group, 3.7% of patients showed unilateral DT (UDT) with contralateral positive effusion, and 5.4% of patients showed bilateral DTs (BDTs). BDT showed a non-B tympanometry pattern and a low rate of recurrence (25.0%), which was similar to the control group. UDT showed a B-type tympanometry in 81.8% of the patients, and the recurrence rate was significantly higher (68.2%; 15/22) than the BDT and control patients. BDT or DT with signs of natural resolution showed a low rate of OME recurrence regardless of tympanometry, and thus, patients do not need a VT. CONCLUSIONS DT was not rare even without GA and the associated time delay, and DT was more common in the children that showed a natural resolution. However, microscopy and tympanometry was imperfect to predict dry tap, and thus, the surgeon needs to be prepared for individualized management of DT. UDT with B-type tympanometry and contralateral persistent effusion frequently recurred without tubes, and thus, VT for UDT appeared to be necessary.
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Affiliation(s)
- Chang Ho Lee
- Department of Otolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam, Gyeonggi-do 463-712, Republic of Korea
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Park YH, Park CH, Kim HJ. The effect of topical sodium thiosulfate in experimentally induced myringosclerosis. Laryngoscope 2010; 120:1405-10. [PMID: 20583241 DOI: 10.1002/lary.20947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS The purpose of this study was to investigate the effect of topical sodium thiosulfate (STS) in experimentally induced myringosclerosis (MS). STUDY DESIGN A prospective experimental animal study. METHODS Thirty Wistar albino rats were bilaterally myringotomized. The right ears were treated with STS or saline daily, and the left ears were left untreated and used as controls. The tympanic membranes were observed by otoendoscopy weekly, and tympanometric measurements were performed. All animals were histopathologically examined for myringosclerotic plaques. RESULTS Under otoendoscopy, myringosclerosis were observed around the handle of the malleus and near the annular region. The numbers of myringosclerotic ears were significantly more frequent in control and saline groups compared with the STS group (P < .05), and the formation of MS was more severe in control and saline groups compared with STS group (P < .05). Using tympanometric measurement, significantly reduced magnitudes of maximum admittance were observed in control and saline groups compared to normal and STS groups (P < .05). Under histopathologic examination, the tympanic membrane of the STS group appeared thinner than the control group (P < .05), with reduced calcium deposition than control and saline groups. CONCLUSIONS Our results show that sodium thiosulfate has a preventive role in the development of myringosclerosis in the experimental animal model.
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Affiliation(s)
- Yong Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, South Korea.
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