1
|
Eğilmez OK, Güven M, Genç Elden S, Budak Ö, Çakıroğlu H, Elden H, Güven EM. The Short-Term Effect of Eugenol on the Prevention of Experimentally Induced Myringosclerosis in a Rat Model. Turk Arch Otorhinolaryngol 2021; 59:124-132. [PMID: 34386799 PMCID: PMC8329402 DOI: 10.4274/tao.2021.6196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/27/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: The aim of our study was to assess the possible short-term effects of topical and oral eugenol on the suppression of experimentally developed myringosclerosis (MS). Methods: Four groups of seven male Wistar albino rats were used in the study. The tympanic membranes (TMs) of all subjects were myringotomized, and group 1 was given no treatment (as control group), group 2 received saline, group 3 had received topical eugenol and group 4 received oral eugenol. Results: In macroscopic evaluation the control and saline groups showed much more MS compared to the topical and oral eugenol groups which had statistically significantly less changes (p<0.05). Fibrosis and inflammation regarding the lamina propria (LP) of the eardrums of the topical and oral eugenol groups were significantly less than those of the control and saline groups (p<0.001). In microscopic evaluation, TMs were found to be thicker in the control and saline groups (p<0.001). Conclusion: Our study showed that the application of topical and oral forms of eugenol reduced fibrosis and prevented the advancement of MS in the LP of the TMs in the short-term. More studies with different extracts are needed to investigate the efficacy of phytotherapeutic agents for preventing MS development following myringotomy.
Collapse
Affiliation(s)
- Oğuz Kadir Eğilmez
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Mehmet Güven
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Sena Genç Elden
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Özcan Budak
- Department of Histology and Embryology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Hüseyin Çakıroğlu
- Sakarya University, Laboratory of Animal Experiments, Sakarya, Turkey
| | - Halil Elden
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | | |
Collapse
|
2
|
Kargin Kaytez S, Kavuzlu A, Yumusak N, Oçal R, Akkoca O. Is there any effect of montelukast on prevention of myringosclerosis after myringotomy in a rat model? Eur Arch Otorhinolaryngol 2018; 276:57-62. [PMID: 30377759 DOI: 10.1007/s00405-018-5181-3] [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: 09/19/2018] [Accepted: 10/20/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES In this study, our aim was to identify the possible effects of montelukast sodium (ML) on the prevention of experimentally induced myringosclerosis. MATERIALS AND METHODS Twenty-eight female Wistar albino rats were used and they were divided into four groups randomly. Tympanic membranes (TM) of all animals were perforated and then group 1 received no treatment (control group), group 2 was treated with a topical saline solution, group 3 received topically ML and group 4 received orally ML. On the 15th day, all animals were euthanized. Tympanic membranes were evaluated otomicroscopically and histopathologically. RESULTS The histopathological findings, compared against a control and saline groups, showed the topically and orally ML groups had statistically significant differences of degree of myringosclerosis (p < 0.002) and median thickness of the TMs (p < 0.001). Suppression of inflammation was statistically significant only in the oral ML treatment group (p < 0.002). CONCLUSION Oral and topically administration of ML reduced myringosclerosis formation in myringotomies rats.
Collapse
Affiliation(s)
- Selda Kargin Kaytez
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Ali Kavuzlu
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Nihat Yumusak
- Department of Pathology, Harran University, Faculty of Veterinary Medicine, Şanliurfa, Turkey
| | - Ramazan Oçal
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ozlem Akkoca
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
3
|
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]
|
4
|
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.
Collapse
Affiliation(s)
- Carla Branco
- ENT Department, Hospital de Vila Franca de Xira, Lisboa, Portugal.
| | - João Paço
- ENT Department, Hospital CUF Infante Santo, Lisboa, Portugal
| |
Collapse
|
5
|
Ağrı İ, Erdal Ağrı A, Sancaktar ME, Ünal A, Can E, Bakırtaş M, Yılmaz F, Demirağ MD, Ünal R. The effect of caffeic acid phenethyl ester (CAPE) on tympanosclerosis. Int J Pediatr Otorhinolaryngol 2017; 95:127-132. [PMID: 28576521 DOI: 10.1016/j.ijporl.2017.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the effects of caffeic acid phenethyl ester (CAPE) on tympanosclerosis. MATERIALS AND METHODS Thirty-two male Sprague Dawley rats were separated into 4 groups as CAPE (n = 10), alcohol (n = 10), control (n = 8) and normal (n = 4) groups. All tympanic membranes except normal group were myringotomised and type 3 Streptococcus pneumoniae strains was injected into their middle ears. Myringotomies were repeated for 5 weeks. Intraperitoneal (i.p) CAPE were administrated to the CAPE group at 10 μmol/kg/day and 10% ethyl alcohol administrated to the alcohol group for 5 weeks. The control group were left untreated. Findings of myringosclerosis were recorded by otomicroscope at sixth week. Then, all rats were sacrificed and tympanic membrane thickness and severity of middle ear mucosal inflammation evaluated histopathalogically. RESULTS Severity of myringosclerosis was significantly higher in the alcohol and control groups compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The tympanic membrane thickness measured in the alcohol and control groups were significantly higher compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The severity of inflammation in the middle ear mucosa was significantly higher in the alcohol and control groups compared to the CAPE group (respectively, p < 0.001, p = 0.03). The severity of inflammation in the middle ear mucosa was not significant between alcohol and control groups (p = 0.30). CONCLUSION CAPE has anti-inflammatory and antioxidant effects on the development of MS in myringotomized rats, so reduces the severity of tympanosclerosis.
Collapse
Affiliation(s)
- İbrahim Ağrı
- Department of Otorhinolaryngology, Samsun Training and Research Hospital, Samsun, Turkey.
| | - Arzu Erdal Ağrı
- Department of Pharmacology, Medical Faculty of 19 Mayıs University, Samsun, Turkey
| | - Mehmet Eser Sancaktar
- Department of Otorhinolaryngology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Asude Ünal
- Department of Otorhinolaryngology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Erkan Can
- Department of Otorhinolaryngology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Mustafa Bakırtaş
- Department of Pathology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Fatih Yılmaz
- Department of Otorhinolaryngology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Mehmet Derya Demirağ
- Department of Internal Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Recep Ünal
- Department of Otorhinolaryngology, Medical Faculty of 19 Mayıs University, Samsun, Turkey
| |
Collapse
|
6
|
Üstündağ M, Koçyiğit M, Bulut E, Altaner Ş, Taş A, Yağız R. Effect of Topical Dexamethasone for Preventing Experimentally Induced Myringosclerosis. Turk Arch Otorhinolaryngol 2017; 55:3-9. [PMID: 29392044 DOI: 10.5152/tao.2017.2077] [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: 11/15/2016] [Accepted: 01/27/2017] [Indexed: 11/22/2022] Open
Abstract
Objective We aimed to examine the effect of topical dexamethasone by otomicroscopic and histologic examinations for preventing myringosclerosis induced by myringotomy in rat tympanic membranes. Methods Twenty-one Sprague Dawley rats (42 ears) were randomly divided into the following three groups after otomicroscopic examinations: experimental surgical group (5 rats), control group (8 rats), and study group (8 rats). The rats of all the groups underwent myringotomy in both tympanic membranes. Other than myringotomy, no additional procedure was performed for the rats in the experimental surgical group. In the control group, 0.9% NaCl was applied to the ears, whereas in the study groups, topical dexamethasone was applied to the ears. These applications in the control and study groups were repeated for nine days. On the 10th day of the study, the rat ears of all groups underwent otomicroscopic and histologic examinations. The prevalence and process of myringosclerosis were evaluated by otomicroscopic examination, whereas inflammation, membrane thickness, and myringosclerosis intensity were evaluated by histologic examination. Results The growth of myringosclerosis with otomicroscopic examination was lesser in the study group in which topical dexamethasone was applied than the control and the experimental surgical groups. Moreover, it was observed that myringosclerosis effected fewer quadrants in the study group.Histologic examinations revealed that inflammation was significantly lesser in the study group than in the experimental surgical and control groups. The average membrane thickness values were significantly lesser in the study group than in the experimental surgical group. With respect to myringosclerosis growth, no statistically significant difference was observed among all groups, whereas with respect to myringosclerosis intensity, the rat ears in the study group were less severely affected. Conclusion Thus, our study results suggest that applying topical dexamethasone after myringotomy has positive effects on limiting the intensity and prevalence of myringosclerosis.
Collapse
Affiliation(s)
- Murat Üstündağ
- Department of Otorhinolaryngology, Trakya University School of Medicine, Edirne, Turkey
| | - Murat Koçyiğit
- Department of Otorhinolaryngology, Trakya University School of Medicine, Edirne, Turkey
| | - Erdoğan Bulut
- Department of Audiology, Trakya University School of Health Sciences, Edirne, Turkey
| | - Şemsi Altaner
- Department of Pathology, Trakya University School of Medicine, Edirne, Turkey
| | - Abdullah Taş
- Department of Otorhinolaryngology, Trakya University School of Medicine, Edirne, Turkey
| | - Recep Yağız
- Department of Otorhinolaryngology, Trakya University School of Medicine, Edirne, Turkey
| |
Collapse
|
7
|
Jung TTK, Alper CM, Roberts JE, Casselbrant ML, Eriksson PO, Gravel JS, Hellström SO, Hunter LL, Paradise JL, Park SK, Spratley J, Tos M, Wallace I. 9. Complications and Sequelae. Ann Otol Rhinol Laryngol 2016. [DOI: 10.1177/00034894051140s113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
8
|
Kokten N, Egilmez OK, Dogan Ekici AI, Kalcioglu MT, Tekin M, Yesilada E. The effect of Nigella sativa oil on prevention of myringosclerosis in a Guinea pig model. Int J Pediatr Otorhinolaryngol 2016; 88:52-7. [PMID: 27497387 DOI: 10.1016/j.ijporl.2016.06.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/10/2016] [Accepted: 06/28/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In this study, our aim was to identify the possible effects of Nigella sativa L. (NS) [blackcumin] seed oil on the prevention of experimentally induced myringosclerosis (MS). MATERIALS AND METHODS Fourteen Guinea pigs were used and they were divided into three groups. Tympanic membranes (TM) of all animals were perforated and then group I was treated with saline soaked gel foams as a control group, group II was treated with 0.5 ml NS oil soaked gel foams at 0, 24 and 48 h and group III was treated with 5 ml NS oil orally at 0, 24, 48, 72 and 120 h. After 15 days, all animals were euthanized. Tympanic membranes were evaluated macroscopically and histopathologically. RESULTS Groups I showed extensive myringosclerosis in contrast to those of Groups II and III which had significantly less changes (p < 0.05). The fibrosis and inflammation in the lamina propria of the tympanic membranes of Groups I was found to be significantly more pronounced (p < 0.05). The tympanic membranes were found to be significantly thinner in Groups II and III when compared with Groups I (p < 0.05). CONCLUSIONS The results of this study suggested that topical or oral administration of NS oil supressed the inflammation and fibroblastic activity in the lamina propria of the myringotomized TMs of the Guinea pigs. For providing further evidence to use plant extracts as antioxidant and antiinflammatory therapy after myringotomy or ventilation tube insertion, further clinical studies with larger population will be essential.
Collapse
Affiliation(s)
- Numan Kokten
- Istanbul Medeniyet University, Faculty of Medicine, Göztepe Training and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
| | | | - A Isin Dogan Ekici
- Yeditepe University, Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - M Tayyar Kalcioglu
- Istanbul Medeniyet University, Faculty of Medicine, Göztepe Training and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
| | - Muhammet Tekin
- Istanbul Medeniyet University, Faculty of Medicine, Göztepe Training and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Erdem Yesilada
- Yeditepe University, Faculty of Pharmacy, Department of Pharmacognosy, Istanbul, Turkey
| |
Collapse
|
9
|
Bilge A, Gunes A, Dagli M, Koybasioglu FF, Guvey A. The impact of topical and systemic enoxaparin sodium use on traumatic tympanic membrane perforation and myringosclerosis. Eur Arch Otorhinolaryngol 2016; 273:3035-41. [PMID: 26796878 DOI: 10.1007/s00405-016-3901-0] [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: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 11/25/2022]
Abstract
The objective of this study is to investigate the effect of topical and systemic enoxaparin sodium on the healing pattern of experimentally induced tympanic membrane perforation and formation of myringosclerosis. A total of 24 Wistar-Albino strain rats were included in the study. Standard myringotomies were performed on each rat. In the first group, isotonic serum physiologic was dropped on external ear canal (control group). Topical enoxaparin was dropped on external ear canal and daily topical doses of enoxaparin were dropped on external ear canal of the rats for 14 days (topical treatment group). Third group received subcutaneous injections of enoxaparin for 14 days (systemic treatment group). Five micrometer thick sections of the bullae of the rats were stained with H&E. Inflammation, edema and sclerotic lesions and neovascularization observed in the lamina propria layer of the tympanic membrane, and total thickness of the tympanic membrane were evaluated. In intergroup comparisons, significant difference in the distribution pattern of severity of inflammation in all three groups was not observed (p = 0.784, p > 0.05). Total TM thickness differed among all three groups (p = 0.028, p < 0.05). A statistically significant difference was observed between the systemic enoxaparin and the control groups (p = 0.022, p < 0.05). A statistically significant difference was observed between the topical enoxaparin and the control groups (p = 0.037, p < 0.05). However, comparison between the topical and systemic treatment groups could not reveal any statistically significant intergroup difference (p = 0.682, p > 0.05). A significant difference was not observed among three groups as for the distribution of myringosclerotic plaques, severity of edema and neovascularization in the lamina propria (p = 0.539, p > 0.05), (p = 0.063, p > 0.05), (p = 0.152, p > 0.05). Topical and systemic enoxaparin treatment did not prevent formation of sclerotic plaques; however, it decreased TM thickness significantly in comparison with the control group.
Collapse
Affiliation(s)
- Arif Bilge
- Department of Otorhinolaryngology, Fatsa State Hospital, Ordu, Turkey.
| | - Akif Gunes
- Department of Otorhinolaryngology, Golbasi Hasvak State Hospital, Ankara, Turkey
| | - Muharrem Dagli
- Department of Otorhinolaryngology, Medical School, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - F Fulya Koybasioglu
- Department of Pathology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ali Guvey
- Department of Otorhinolaryngology, Medical School, Dumlupinar University, Kutahya, Turkey
| |
Collapse
|
10
|
The effect of Hypericum perforatum L. (St. John's Wort) on prevention of myringosclerosis after myringotomy in a rat model. Int J Pediatr Otorhinolaryngol 2015; 79:1128-34. [PMID: 26022750 DOI: 10.1016/j.ijporl.2015.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/07/2015] [Accepted: 05/10/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The purpose of this study was to identify the possible effects of Hypericum Perforatum (HP) on the prevention of experimentally induced myringosclerosis (MS). METHODS Twenty eight Wistar Albino rats were used and they were divided into four groups. Tympanic membranes of all animals were perforated and then group I had no treatment as a control group, group II had treated with olive oil only, group III had treated with HP orally and group IV had treated with HP topically. RESULTS Groups I and II showed extensive myringosclerosis in contrast to those of Groups III and IV which had significantly less changes (p<0.05). The inflammation and fibrosis in the lamina propria of the tympanic membranes of Groups I and II were found to be significantly more pronounced (p<0.05). The tympanic membranes were found to be significantly thinner in Groups III and IV when compared with Groups I and II (p<0.05). CONCLUSIONS The results of the present study suggested that oral or topical administration of HP extract after myringotomy suppressed the inflammation and fibroblastic activity in the lamina propria of the myringotomized TMs of the rats. Further clinical studies with larger population using HP and other antioxidants will be essential to provide further evidence for use of antioxidant therapy in patients with myringotomy and ventilation tube insertion for otitis media with effusion.
Collapse
|
11
|
Do all antioxidant supplements have the same potential effect on preventing myringosclerosis? Clin Exp Otorhinolaryngol 2015; 8:1-6. [PMID: 25729488 PMCID: PMC4338085 DOI: 10.3342/ceo.2015.8.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 10/14/2013] [Accepted: 10/29/2013] [Indexed: 11/24/2022] Open
Abstract
Objectives Myringosclerosis is an irreversible pathological healing mechanism of the tympanic membrane which can result in the formation of sclerotic plaques. Antioxidant treatment is a recognised prevention therapy and coenzyme Q10 (CoQ10), lycopene, and grape seed extract (GSE), were used in this manner. Methods Forty-four Wistar rats were used in this experiment, and, following myringotomies, the animals were randomly divided into four groups. CoQ10, lycopene or GSE was administered orally to the respective groups, starting from the day of surgery. Otomicroscopy examination was performed on the 14th day. All tympanic membrane lesions were evaluated and compared otomicroscopically and histopathologically. Results The otomicroscopy and histopathological findings, compared against a control (saline) group, showed the CoQ10, lycopene, and GSE groups had statistically significant differences of degree of sclerosis (P<0.001). Conclusion CoQ10, lycopene, and GSE were compared against a saline group and their antioxidative and anti-inflammatory effects were similar. The formation of myringosclerotic plagues after experimental myringotomy in rats significantly decreased and diminished after systemic administration of the three different antioxidant supplements.
Collapse
|
12
|
Sahin ED, Yalcın S, Halil Ozercan I, Kaygusuz I, Karlıdag T, Keles E, Akyigit A. The effect of lycopene on experimental myringosclerosis. Int J Pediatr Otorhinolaryngol 2015; 79:342-8. [PMID: 25583088 DOI: 10.1016/j.ijporl.2014.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/14/2014] [Accepted: 12/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the effect of lycopene on myringosclerosis development using histopathological and immunohistochemical analyses. METHODS Fifty-six intact tympanic membranes of 28 guinea pigs were included in the study. Subjects were randomly divided into four groups (n=7/group). Group I (control group) did not receive any treatment after myringotomy. Group II (lycopene treatment after myringotomy) received oral lycopene (once daily at the same time, 10mg/kg, dissolved in water, administered with a catheter). The treatment lasted seven days. Group III (lycopene treatment before and after myringotomy), received lycopene treatment (same dose and route of administration) for seven days. Myringotomy was performed on day 8, and lycopene treatment was initiated immediately, and continued for seven days (same dose and route of administration). Group IV (lycopene treatment before myringotomy) received lycopene treatment one week before myringotomy using the same method and dose for seven days. Myringotomy was performed on day 8. Lycopene was not administered after myringotomy. Fourteen days after myringotomy, myringosclerosis was evaluated automicroscopically and scored. Following decapitation, bulla were removed and immersed in a 10% formaldehyde solution. Sections were cut for histopathological and immunohistochemical examination, and thickness, sclerosis, inflammation, and collagen-IV accumulation were scored semi-quantitatively. RESULTS In the present study, the level of myringosclerosis was significantly lower in lycopene-treated groups compared to the control group (p<0.05). In addition, thickness, inflammation, sclerosis, and collagen-IV accumulation were significantly lower in the lycopene-treated groups compared to the control group (p<0.05). The timing of lycopene administration - i.e. before and/or after surgery - did not cause any difference with respect to myringosclerosis development. CONCLUSION Lycopene, a strong antioxidant, may represent a good alternative treatment to prevent the development of myringosclerosis.
Collapse
Affiliation(s)
- Evin Das Sahin
- Bingöl Government Hospital, Clinic of ENT, Bingöl, Turkey
| | - Sinasi Yalcın
- Fırat University Faculty of Medicine, Department of ENT, Elazığ, Turkey
| | | | - Irfan Kaygusuz
- Fırat University Faculty of Medicine, Department of ENT, Elazığ, Turkey
| | - Turgut Karlıdag
- Fırat University Faculty of Medicine, Department of ENT, Elazığ, Turkey
| | - Erol Keles
- Fırat University Faculty of Medicine, Department of ENT, Elazığ, Turkey
| | | |
Collapse
|
13
|
Does systemic clarithromycin therapy have an inhibitory effect on tympanosclerosis? An experimental animal study. The Journal of Laryngology & Otology 2015; 129:136-41. [DOI: 10.1017/s0022215114003430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To demonstrate the inhibitory effects of clarithromycin on in vitro tympanosclerosis.Method:Twenty-eight rats were divided into three groups: a clarithromycin group, a non-clarithromycin group and a negative control group. Those in the first two groups were injected with Streptococcus pneumoniae following a myringotomy, and tympanosclerosis was experimentally induced. Oral clarithromycin therapy was administered in the clarithromycin group. The other groups received no medical treatment.Results:All eardrums in the clarithromycin and non-clarithromycin groups developed myringosclerosis, but there was only one eardrum, in the clarithromycin group, with very severe myringosclerosis. In the clarithromycin group, 11 ears showed no inflammation and there were no ears with severe inflammation. In the non-clarithromycin group, there were 11 ears with severe inflammation. The mean eardrum thickness in the clarithromycin group was 20.93 µm and in the non-clarithromycin group it was 42.71 µm.Conclusion:Acute otitis media and myringotomies induced tympanosclerosis, but clarithromycin reduced the severity of tympanosclerosis.
Collapse
|
14
|
Dündar R, İnan S, Muluk NB, Cingi C, İlknur AE, Katılmış H. Inhibitory effect of N-acetyl cysteine and ascorbic acid on the development of myringosclerosis: an experimental study. Int J Pediatr Otorhinolaryngol 2014; 78:1019-25. [PMID: 24794623 DOI: 10.1016/j.ijporl.2014.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 03/14/2014] [Accepted: 03/29/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study investigated the effects of ascorbic acid and N-acetyl cysteine (NAC) antioxidants on the development of myringosclerosis (MS) in an experimental model. METHODS Myringotomies were performed in the ears of 15 guinea pigs, and Spongostan pieces were placed on the perforated regions of the tympanic membrane. The subjects were divided randomly into three groups and treated with three different solutions on the Spongostan-group 1: (control, 0.9% saline), group 2 (ascorbic acid), and group 3 (NAC). On day 15 after treatment, specimens from the tympanic membranes were obtained and examined via light microscopy. Sclerosis and inflammation scores and the tympanic membrane thicknesses were evaluated. Immunohistochemical methods were used to evaluate the expression of VEGF, TGF-β, iNOS, and IL1-β in all groups. RESULTS Lower sclerosis and inflammation scores and reduced tympanic membrane thicknesses were observed in groups treated with NAC or ascorbic acid compared with the control group. Immunohistochemical studies revealed significantly less expression of VEGF, TGF-β, and iNOS in groups 2 and 3 compared with group 1. Additionally, IL1-β expression was significantly less in group 3 than in group 1. Compared with group 1, group 2 animals exhibited reduced inflammation in the lamina propria, fewer active fibroblasts, less leukocyte infiltration, and decreased thickness of the vessels; group 3 animals exhibited decreased numbers of active fibroblasts and collagen fibers in the lamina propria. CONCLUSIONS Inflammation scores, cellular infiltration, and expression of VEGF, TGF-β, and iNOS were reduced by ascorbic acid and/or NAC treatments, thereby decreasing MS development. Decreased expression of IL1-β was observed only in animals treated with NAC.
Collapse
Affiliation(s)
- Rıza Dündar
- Kızıltepe State Hospital, ENT Department, Mardin, Turkey
| | - Sevinç İnan
- Celal Bayar University, Faculty of Medicine, Histology and Embryology Department, Manisa, Turkey
| | - Nuray Bayar Muluk
- Kırıkkale University, Faculty of Medicine, ENT Department, Kırıkkale, Turkey.
| | - Cemal Cingi
- Osmangazi University, Medical Faculty, Department of Otorhinolaryngology, Eskisehir, Turkey
| | | | - Hüseyin Katılmış
- İzmir Katip Çelebi University, Training and Research Hospital, ENT Clinics, İzmir, Turkey
| |
Collapse
|
15
|
Effect of caffeic acid phenethyl ester on myringosclerosis development in the tympanic membrane of rat. Eur Arch Otorhinolaryngol 2013; 272:29-34. [DOI: 10.1007/s00405-013-2832-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
|
16
|
Aydoğan F, Aydin E, Taştan E, Akgedik Ş, Tekeli A, Üstün H. Is there any effect of coenzyme Q10 on prevention of myringosclerosis? Experimental study with rats. Braz J Otorhinolaryngol 2013; 79:293-7. [PMID: 23743743 PMCID: PMC9443869 DOI: 10.5935/1808-8694.20130053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 03/04/2013] [Indexed: 11/20/2022] Open
Abstract
Objective Method Results Conclusion
Collapse
Affiliation(s)
- Filiz Aydoğan
- Department of Otorhinolaryngology, Ankara Training and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
17
|
Sakalli E, Baylancicek S, Yuksel M, Erdurak SC, Dadas B. Levels of reactive oxygen species in rat tympanic membranes after incisional versus radiofrequency myringotomy. Int J Pediatr Otorhinolaryngol 2013; 77:792-5. [PMID: 23478016 DOI: 10.1016/j.ijporl.2013.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 02/10/2013] [Accepted: 02/12/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE A close relationship between reactive oxygen species (ROS) and myringosclerosis, which is a common complication of myringotomy, was recently reported. The objective of this study was to measure ROS levels directly in rat tympanic membranes using luminol-aided chemiluminescence (CL) in order to compare the levels of ROS after incisional and radiofrequency (RF) myringotomy. METHODS Fifteen Sprague-Dawley rats were separated into three groups of five animals each. Bilateral myringotomies were made using an appropriate myringotomy lancet in Group 1 and RF in Group 2. Group 3 served as the control group with no myringotomy. Twenty-four hours after the procedure, all tympanic membranes were inspected with an otomicroscope and then excised for the measurement of ROS using luminol-aided CL. RESULTS The mean ROS level in Group 1 was significantly higher than that in Groups 2 and 3 (p<0.05 for both). The difference in mean ROS level between Groups 2 and 3 was not significant (p>0.05). Otomicroscopy revealed increased vascularity and vessel dilation in all tympanic membranes that underwent myringotomy. Vascular dilation was observed in the annular region in the vessels that passed along the long arm of the malleus, in addition to the vessels feeding the anterior and posterior tympanomalleolar folds. CONCLUSIONS Although the relationship between ROS and the development of myringosclerosis after myringotomy has been demonstrated, the present study is the first to compare incisional and RF myringotomy based on the measurement of ROS levels. Our results indicate that the increase in ROS due to myringotomy was greater following incisional myringotomy than RF myringotomy.
Collapse
Affiliation(s)
- Erdal Sakalli
- Sisli Etfal Training and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
18
|
Effect of local use of L-carnitine after myringotomy on myringosclerosis development in rats. The Journal of Laryngology & Otology 2013; 127:468-72. [PMID: 23552281 DOI: 10.1017/s002221511300056x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study aimed to investigate the effect of local and intraperitoneal administration of L-carnitine on the prevention of experimentally induced myringosclerosis, and to compare treatment efficiency. METHODS Twenty-four Albino-Wistar rats (48 ears) were bilaterally myringotomised and divided randomly into four groups: group one received no treatment, group two received intraperitoneal L-carnitine, group three received local L-carnitine, and group four received both intraperitoneal and local L-carnitine. On the 15th day after treatment, tympanic membranes were harvested and evaluated histopathologically for myringosclerotic plaque formation, fibroblastic proliferation, tympanic membrane thickness and new vessel formation. RESULTS The group one tympanic membranes showed extensive thickness, and the incidence of myringosclerosis and fibroblast proliferation were greater than in groups two and four. There were statistically significant differences in tympanic membrane thickness between groups three and four, and in myringosclerosis incidence and fibroblast proliferation, comparing groups two, three and four. CONCLUSION Myringosclerosis development was significantly reduced in rats receiving myringotomy plus intraperitoneal L-carnitine. Intraperitoneal L-carnitine administration prevented fibroblastic proliferation and tympanic membrane thickening (both of which cause further tympanic membrane destruction), thus reducing myringotomy-associated morbidity. Local L-carnitine administration had limited effectiveness in this experimental setting.
Collapse
|
19
|
Arslan N, Tepe D, Taştan E, Demirci M, Caydere M, Ustun H, Oguz H. Evaluation of the effectiveness of topical ciprofloxacin and prednisolone in the prevention of myringosclerosis. Eur Arch Otorhinolaryngol 2011; 269:2335-41. [DOI: 10.1007/s00405-011-1889-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 12/12/2011] [Indexed: 01/19/2023]
|
20
|
Dogan E, Erdag TK, Sarioglu S, Ecevit MC, Ikiz AO, Güneri EA. The preventive effect of N-nitro L-arginine methyl ester in experimentally induced myringosclerosis. Int J Pediatr Otorhinolaryngol 2011; 75:1035-9. [PMID: 21669465 DOI: 10.1016/j.ijporl.2011.05.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 05/17/2011] [Accepted: 05/17/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the antiinflammatory and antifibrotic effects of N-nitro L-arginine methyl ester (L-name) in experimentally induced myringosclerosis. METHODS Twenty Wistar albino rats were bilaterally myringotomized and divided randomly into four groups, each including five rats. Group I received no treatment, Group II was treated with topical saline solution, Group III received topical L-NAME and Group IV received intraperitoneally administered L-NAME. After 2 weeks, the tympanic membranes were examined and scored by otomicroscopy regarding the extent of the myringosclerosis. Then the tympanic membranes were harvested and evaluated histopathologically by light microscopy. The intensity of inflammation and degree of myringosclerosis were evaluated, the mean thickness of tympanic membranes were also measured. RESULTS The tympanic membranes of Groups I and II showed extensive myringosclerosis in contrast to those of Groups III and IV which had significantly less or no changes (p < 0.05). The inflammation and fibroblastic activity of the lamina propria in the tympanic membranes of Groups III and IV were found to be significantly less pronounced (p < 0.05). The tympanic membranes were found to be significantly thicker in Groups I and II when compared with Groups III and IV (p < 0.05). CONCLUSION Our results showed that both topical and intraperitoneal applications of L-NAME supressed inflammation, reduced fibroblastic proliferation and decreased the formation of myringosclerosis in myringotomized rat tympanic membranes.
Collapse
Affiliation(s)
- Ersoy Dogan
- Dokuz Eylul University School of Medicine, Department of Otorhinolaryngology Head and Neck Surgery, Izmir, Turkey.
| | | | | | | | | | | |
Collapse
|
21
|
Antioxidant effect of pomegranate extract in reducing acute inflammation due to myringotomy. The Journal of Laryngology & Otology 2011; 125:370-5. [PMID: 21349238 DOI: 10.1017/s002221511000263x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the effect of pomegranate extract on acute inflammation due to myringotomy. DESIGN Prospective, randomised study. SUBJECTS Thirty Sprague-Dawley rats were divided into three groups. Group one constituted controls. Group two underwent myringotomy. Group three underwent myringotomy and also received 100 µl/day pomegranate extract, via gavage, one day before and two days after surgery. Following sacrifice 48 hours after myringotomy, the animals' right ears were used to determine the concentration of reactive oxygen species, using the chemiluminescence method; left ears were used for histological study. RESULTS Reactive oxygen species levels were significantly decreased in group three compared with group two (p < 0.01). The density of inflammatory cells in group three was significantly less than that in group two (p < 0.01). Lamina propria thickness and vessel density were also significantly decreased in group three compared with group two (p < 0.01). CONCLUSION Our results indicate that oral pomegranate extract decreases reactive oxygen species concentration and acute inflammation in the tympanic membrane after myringotomy.
Collapse
|
22
|
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.
Collapse
Affiliation(s)
- Yong Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, South Korea.
| | | | | |
Collapse
|
23
|
Yaman H, Guclu E, Yilmaz S, Ozturk O. Myringosclerosis after tympanostomy tube insertion: relation with tube retention time and gender. Auris Nasus Larynx 2010; 37:676-9. [PMID: 20392579 DOI: 10.1016/j.anl.2010.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 01/25/2010] [Accepted: 02/15/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine relationship between myringosclerosis and tube retention time and sex in children with chronic otitis media with effusion who were treated with tympanostomy tube insertion. Also, the relationship between myringosclerosis both sex and initial age of tube insertion were investigated. METHODS A total of 101 children (195 ears) were reviewed. Ears were divided into four groups according to retention time of tympanostomy tubes. Group I: Retention time of tympanostomy tube less than 6 months. Group II: Retention time of tympanostomy tube from 6 months to 12 months. Group III: Retention time of tympanostomy tube of 12 months or more. Group IV: Myringotomy group without tympanostomy tube insertion. RESULTS The order of the myringosclerosis rates were as follows from the highest to lowest one; group III (44.1%), group II (42.4%), group I (14.3%), and group IV (7.7%). Myringosclerosis was more common in group I compared with group IV, but the difference was statistically not significant (p>0.05). There were no statistically significant differences in myringosclerosis rates between the group II and group III (p>0.05). On the other hand, statistically significant differences were observed in myringosclerosis rates between group I and group II (p<0.05), and between group I and group III (p<0.05); also similar significant differences were present in myringosclerosis rates between group IV and group II (p<0.05), and between group IV and group III (p<0.05). There was no significant difference between preschool age group and school age group. Myringosclerosis was observed in 40% of boys and in 51.2% of girls. CONCLUSION Myringosclerosis is frequent in patients who underwent tympanostomy tube insertion. The frequency of myringosclerosis is much higher in tympanic membranes with tympanostomy tube insertion than tympanic membranes with myringotomy, and the location of sclerotic plaques does not always correspond to the tympanostomy area. The myringosclerosis rate was increased when the tympanostomy tubes stay on tympanic membrane for a long time. Highest myringosclerosis rates were observed if the extrusion time was 12 months or longer. In our analysis, sex and initial age of tube insertion were not significant factors for the development of myringosclerosis after extrusion of tympanostomy tubes.
Collapse
Affiliation(s)
- Huseyin Yaman
- Duzce University, Duzce Medical Faculty, Department of Otorhinolaryngology, Turkey.
| | | | | | | |
Collapse
|
24
|
Kaptan ZK, Emir H, Gocmen H, Uzunkulaoglu H, Karakas A, Senes M, Samim E. Ginkgo biloba, a free oxygen radical scavenger, affects inflammatory mediators to diminish the occurrence of experimental myringosclerosis. Acta Otolaryngol 2009; 129:826-31. [PMID: 18932046 DOI: 10.1080/00016480802468120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION Systemic Ginkgo biloba extract treatment reduces the levels of nitrite/nitrate, malondialdehyde, and superoxide dismutase and increases the levels of glutathione peroxidase. By scavenging free oxygen radicals, ginkgo extract prevents the formation of myringosclerosis. OBJECTIVE Our objective was to evaluate inflammatory mediators to determine the antioxidant and anti-inflammatory effect of Ginkgo biloba extract to diminish myringosclerosis. MATERIALS AND METHODS Thirty Wistar Albino rats, weighing 320-400 g were used. The upper posterior quadrants of both tympanic membranes were myringotomized and divided into four groups. Ginkgo biloba extract was given orally to groups 1 and 2 comprising eight rats with doses of 100 mg/kg/day and 200 mg/kg/day, respectively. Seven rats in group 3 received 1.5 ml/day saline and seven rats were left untreated. After 10 days of treatment, otomicroscopic evaluation of tympanic membranes and measurement of anti-inflammatory mediators such as superoxide dismutase, nitrite/nitrate, glutathione peroxidase and malondialdehyde were performed. RESULTS Myringosclerosis was significantly more severe in control and saline groups than in Ginkgo biloba groups. The levels of nitrite in ginkgo-treated groups were significantly lower than in untreated and saline-treated groups, while glutathione peroxidase levels were significantly higher. The levels of malondialdehyde and superoxide dismutase were lower in ginkgo groups but not significantly.
Collapse
|
25
|
Alpay HC, Etem EO, Kaygusuz I, Yüce H, Karlidag T, Keles E, Orhan I, Yalcin S. Evaluation of the polymorphism in the Toll-like receptor 4 (TLR4) genes of tympanosclerosis patients. Auris Nasus Larynx 2009; 37:29-32. [PMID: 19398177 DOI: 10.1016/j.anl.2009.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 02/28/2009] [Accepted: 03/05/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although eardrum perforations which endure etiopathogenesis for a long-time and middle ear infections are proposed for causing the tympanosclerosis (TS), tympanosclerosis emerges in some chronic otitis media (COM), some of them do not appear although a continuing COM and enduring perforation last. In this study, the effect of the molecular reasons which display genetic differences in TS formation is evaluated; our aim is to determine the Asp299Gly polymorphism frequencies in the TLR4 gene of patients with TS who have COM, and patients who do not. MATERIALS AND METHODS Patients who have undergone COM surgery, were divided into two groups of 50 persons who were selected in accordance with the fact, whether they had TS in their middle ear cavity or not during operation. 100 healthy persons who had similar demographic data, were evaluated as the control group. The DNA isolation was executed by using standard methods with peripheric blood specimen of the diseased group and control group. The Restriction Fragment Length Polymorphism method was used in determining the Asp299Gly allel in the TLR4 gene. Items of 249 bc for the wild tip (Asp) post-restriction enzyme segment wild tip (Asp) allel, and 23 bc and 196 bc post-restriction enzyme segment polymorphic allel (Gly) were obtained. RESULTS TLR4 Asp299Gly polymorphism (10%) was asserted in a total of five specimens in the diseased group with TS. TLR4 Asp299Gly polymorphism was found positive in only one (2%) of the 50 phenomenons in the group without TS. TLR4 Asp299Gly polymorphism was found positive in six (6%) of the 100 phenomenons in the control group. The positive polymorphism in phenomenons with TS was significant in accordance with statistics, when compared with the group without TS (p<0.05). However, although the polymorphism rates were higher than the rates of the control group, it was not statistically significant (p>0.05). CONCLUSION TS may not appear in many patients who had undergone middle ear infection, and had perforation for many years. The polymorphism in arteriosclerosis in the TLR4 gene which caused the inflammatory cytokines oscillation recognize the bacterial LPS, was also accused. It is engrossing to find out from the results of our study on a restricted number of patients, and on only one gene, that molecular reasons which display genetic differences can also be effective in forming TS. Serial researches of greater dimensions are required.
Collapse
Affiliation(s)
- Hayrettin Cengiz Alpay
- Department of Otorhinolaryngology, Firat University, Medical Faculty, 23200 Elazig, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Emir H, Kaptan ZK, Samim E, Sungu N, Ceylan K, Ustun H. The preventive effect of ginkgo biloba extract in myringosclerosis: study in rats. Otolaryngol Head Neck Surg 2009; 140:171-6. [PMID: 19201283 DOI: 10.1016/j.otohns.2008.10.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 10/06/2008] [Accepted: 10/16/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the preventive effect of Ginkgo biloba extract in the formation of myringosclerosis. STUDY DESIGN Prospective, randomized clinical study. MATERIALS AND METHODS Posterosuperior quadrant of tympanic membranes of twenty-five Wistar Albino rats were bilaterally myringotomized. They were divided into three groups randomly. Groups 1 and 2 were administered 100 mg/kg/day and 200 mg/kg/day systemic Ginkgo biloba extract. The third group was treated with 1 mL/day saline solution. After 10 days of treatment, myringotomized membranes were examined by otomicroscopy and harvested. They were evaluated histopathologically by light microscopy and compared according to the occurrence of myringosclerotic plaques and the thickness of membranes. RESULTS Tympanic membranes of groups 1 and 2 nearly had no existence of myringosclerosis (72.2% in group 1 and 83.3% in group 2, P = 0.434). However, in group 3, only 14.3 percent had no myringosclerosis (P < 0.001). Thickness of membranes in group 1 was 0.13 +/- 0.25, group 2 was 0.06 +/- 0.02, and group 3 was 0.19 +/- 0.35 mm. Group 3 had significantly thicker membranes compared with groups 1 and 2 (P < 0.001 for group 2 and P = 0.003 for group 1). CONCLUSION Formation of experimental myringosclerosis was reduced or inhibited and tympanic membranes were thinner after systemic Ginkgo biloba extract administration.
Collapse
Affiliation(s)
- Hatice Emir
- Otorhinolaryngology Clinic, Ministry of Health, Ankara Training and Research Hospital, Turkey.
| | | | | | | | | | | |
Collapse
|
27
|
The Effect of Topical Doxycycline in the Prevention of Experimental Tympanosclerosis. Laryngoscope 2008; 118:1051-6. [DOI: 10.1097/mlg.0b013e31816770ba] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
28
|
Topical Application of Calcium Channel Blockers to Reduce the Progression of Experimentally Induced Myringosclerosis and Tympanosclerosis. Laryngoscope 2008; 118:697-705. [DOI: 10.1097/mlg.0b013e31815ed115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Giles B. Wound Healing in Spontaneous Perforation or Myringotomy and Middle Ear Reconstruction. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708611s11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
30
|
Song JJ, Kwon SK, Cho CG, Park SW. The effect of caffeic acid phenethyl ester on the prevention of experimentally induced myringosclerosis. Int J Pediatr Otorhinolaryngol 2007; 71:1287-91. [PMID: 17544518 DOI: 10.1016/j.ijporl.2007.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 05/02/2007] [Accepted: 05/02/2007] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Myringosclerosis is a common sequela of ventilation tube insertion for the treatment of the otitis media with effusion. Several antioxidants have been identified to prevent myringosclerosis. The objective of this study was to investigate the effect of caffeic acid phenethyl ester (CAPE) on the prevention of experimentally induced myringosclerosis. METHODS Thirty-five Sprague-Dawley rats were unilaterally myringotomized. The rats were divided into four groups randomly: group 1 received no treatment, group 2 received intraperitoneally administered saline and group 3 received intraperitoneally administered CAPE. The tympanic membranes were examined by otomicroscopy on the 15th day after treatment. The membranes were then harvested and evaluated histologically by light microscopy. RESULTS The tympanic membranes from group 1 showed extensive myringosclerosis; those from group 2 showed a similar occurrence of myringosclerosis. However, group 3 had a reduced occurrence of myringosclerosis by otomicroscopic evaluation. Under light microscopic examination, the lamina propria of the pars tensa was found to be thicker and more sclerotic in groups 1 and 2 when compared with group 3. CONCLUSIONS Systemic treatment with CAPE was found to be effective in the prevention of sclerotic lesions in myringotomized rat tympanic membranes.
Collapse
Affiliation(s)
- Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University International Hospital, 814 Siksa-Dong, Goyang, Gyeonggi 410-773, South Korea.
| | | | | | | |
Collapse
|
31
|
Kazikdas KC, Uguz MZ, Erbil G, Tugyan K, Yilmaz O, Guneli E, Altun Z. The Anti-Oxidant Effect of Alpha-Tocopherol in the Prevention of Experimentally Induced Myringosclerosis. Otol Neurotol 2006; 27:882-6. [PMID: 16788415 DOI: 10.1097/01.mao.0000224089.00721.8d] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The objective of this study was to investigate the possible effect of alpha-tocopherol on the prevention of experimentally induced myringosclerosis. BACKGROUND Myringosclerosis is a common sequela of ventilation tube treatment of otitis media with effusion. The relationship between oxygen-derived free radicals and occurrence of myringosclerosis has been proven in experimental models, and it was also shown that the formation of myringosclerosis after experimental myringotomy could be reduced by application of various free radical scavengers. METHODS Eighteen Wistar albino rats were myringotomized on the left side and randomly separated into two groups: group A consisted of rats which received intramuscular alpha-tocopherol injections 100 mg/kg daily and group B which were injected with physiological serum only. The occurrence of myringosclerotic plaques in the tympanic membranes of the two groups was compared by otomicroscopy, histopathology, and tympanometry, which is a novel method of quantification. Blood samples were collected for biochemical evaluation, and the tympanic membranes were harvested on the 15th day of the experiment. RESULTS In otomicroscopic evaluation, tympanic membranes in group B revealed varying degrees of myringosclerotic plaques; on the other hand, tympanic membranes in group A showed faint or no existence of myringosclerosis. The mean malondialdehyde levels were 1.33 +/- 0.11 micromol/L in group A and 7.49 +/- 1.37 micromol/L in group B (Z = -1.906, p = 0.057). In all ears from group B, the magnitude of the maximum admittance measured by tympanometry reduced to approximately 40% of the values obtained from group A (Z = -2,160, p = 0.031). The mean magnitude of the maximum admittance from group A was very close to the standardization values of Wistar albino rats, which predicts a functional outcome. CONCLUSION The formation of myringosclerosis after experimental myringotomy can be diminished by intramuscular alpha-tocopherol injections.
Collapse
Affiliation(s)
- K Cagdas Kazikdas
- Department of Otorhinolaryngology, Ataturk Training and Research Hospital, Izmir, Turkey.
| | | | | | | | | | | | | |
Collapse
|
32
|
Uneri C, Bağlam T, Yazici M. The effect of Vitamin E treatment on the development of myringosclerosis after ventilation tube insertion. Int J Pediatr Otorhinolaryngol 2006; 70:1045-8. [PMID: 16368152 DOI: 10.1016/j.ijporl.2005.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2005] [Revised: 10/27/2005] [Accepted: 10/27/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Recent studies have established the relationship between the reactive oxygen species and myringosclerosis. Furthermore several antioxidants have been known to prevent myringosclerosis. All the previous studies supporting this hypothesis have been performed on animals. The aim of our study is to investigate the possible effect of Vitamin E on the development of tympanosclerosis after VT insertion on human subjects. METHODS 72 children undergoing myringotomy and VT insertion were included in the study. Vitamin E was applied to the right ear and no treatment was applied to the left ear. Both ears were examined at the end of 9 months with otomicroscopy. Myringosclerosis formation at the end of the study period was noted for each ear. RESULTS Myringosclerosis was found in 33 of the 144 ears. The overall incidence was 22.9%. While 22 (30.6%) of the 72 left ears showed myringosclerosis otomicroscopically, in only 11 (15.3%) of the 72 right ears that were treated with Vitamin E was myringosclerosis observed at the end of the study period. Of these nine cases were bilateral. CONCLUSION Animal studies have well documented the development of myringosclerosis after myringotomy and VT insertion and beneficial effects of different antioxidants. Our study has shown similar results in human subjects. Further clinical studies consisting of a larger patient population are needed to bring about routine clinical use of antioxidants in myringotomy and VT insertion.
Collapse
Affiliation(s)
- Cüneyd Uneri
- Marmara University School of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey.
| | | | | |
Collapse
|
33
|
Kazikdas KC, Serbetcioglu B, Boyraz I, Tugyan K, Erbil G, Yilmaz O, Onal K. Tympanometric Changes in an Experimental Myringosclerosis Model After Myringotomy. Otol Neurotol 2006; 27:303-7. [PMID: 16639266 DOI: 10.1097/00129492-200604000-00003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The goal of this experimental study was to investigate the specific effect of myringosclerosis on tympanograms in the tympanic membranes of myringotomized rats by using otomicroscopy, tympanometry, and histopathology. BACKGROUND Myringosclerosis is a common sequela of ventilation tube treatment of otitis media with effusion. The condition involves the hyalinization and calcification of the collagen layer in certain areas of the tympanic membrane. Previous animal experiments suggest an intimate relationship between the formation of myringosclerosis and an increased oxygen concentration in the environment of the wound after myringotomy. The result of a myringotomy therefore is an increased production of free oxygen radicals, initiating irreversible tissue damage involving fibrosis, hyalin degeneration, and finally apoptosis as observed in myringosclerosis. We propose an experimental model specific for creating sclerotic plaques solely on the tympanic membrane and for performing tympanometric measurements on this pure myringosclerosis model without creating any abnormality in the middle ear to test in what proportion myringosclerosis contributes to decrease of amplitude in tympanograms. METHODS To assess the normal tympanometric values of Wistar albino rats, the pressure and peak admittance of the left middle ears were measured using a semiquantitative computerized clinical admittance meter using a sound frequency of 226 Hz. Twelve animals were randomly selected for the myringotomy group and perforations in the left ears were created. All tympanic membrane perforations in this group had healed and closed prior to the otomicroscopic examination and no pathologic reaction was observed in the external ear canals of rats. Otomicroscopic and tympanometric measurements were carried out on Day 15 and the degree of myringosclerosis was noted before the animals were killed. Twelve specimens in the myringotomy group were histopathologically examined for the presence of myringosclerotic plaques. RESULTS Under light microscopy, extensive sclerotic lesions were found in the tympanic membranes of the myringotomy group, and these sclerotic deposits were located in the lamina propria. The myringosclerosis occurred predominantly adjacent to the handle of the malleus, but also near the annular region. In all ears with myringosclerosis, the magnitude of the maximum admittance reduced to approximately 50% of the Day-0 values, and this reduction was statistically significant (Z=-3.061, p=0.002). CONCLUSION The present findings in this study are consistent with the fact that the movement of the tympanic membrane is hampered by lesions of sclerotic material, resulting in a decrease of amplitude in tympanograms (such as Type As) without any effusion or inflammation in the middle ear.
Collapse
Affiliation(s)
- K Cagdas Kazikdas
- Department of Otorhinolaryngology, Ataturk Training and Research Hospital, and Department of Otorhinolaryngology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
| | | | | | | | | | | | | |
Collapse
|
34
|
Santos PF, Leal MC, Peixoto C, Neto SC, Rosas STP. Otomicroscopic and histologic findings of induced myringosclerosis in rats: a critical study of an experimental model. Braz J Otorhinolaryngol 2006; 71:668-74. [PMID: 16612530 PMCID: PMC9442119 DOI: 10.1016/s1808-8694(15)31272-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED Myringosclerosis is characterized by hyaline changes of the lamina propria of the tympanic membrane. Experimental studies have used otomicroscopy or histology to evaluate myringosclerosis in animals, but they do not correlate precisely these two methods. AIM The present study evaluates the accuracy of otomicroscopy in the diagnosis of myringosclerosis in rats. STUDY DESIGN Experimental. MATERIAL AND METHOD Myringosclerosis was induced by transtympanic inoculation of Streptococcus pneumoniae in 25 Wistar rats, which were examined weekly through otomicroscopy and sacrificed after eight weeks for histologic study of their tympanic membranes. RESULTS From the comparison of the otomicroscopic data in relation to the histologic findings, we could observe sensibility of 80% and specificity of 75% for the otomicroscopy. CONCLUSION Considering the results in this study, otomicroscopy did not represent a good method to evaluate myringosclerosis in this experimental model.
Collapse
Affiliation(s)
| | - Mariana C. Leal
- Post-graduation in Otorhinolaryngology under course, University of Sao Paulo. Deputy Professor, Department of Surgery, Federal University of Pernambuco
| | - Cristina Peixoto
- Ph.D., Joint Professor, Department of Molecular Biology, Centro de Pesquisas Aggeu Magalhães
| | - Silvio Caldas Neto
- Joint Professor, Discipline of Otorhinolaryngology, Federal University of Pernambuco. Head of the service of Otorhinolaryngology, Hospital das Clínicas, Federal University of Pernambuco
- Address correspondence to: Silvio Caldas – Rua Poeta Zezito Neves 38 ap. 1801 Recife PE 51020-200. Tel./Fax: (55 81) 3427-4610
| | - Silvania Tavares Paz Rosas
- Histotechnician, Master studies, Department of Pathology, Hospital das Clínicas, Federal University of Pernambuco
| |
Collapse
|
35
|
Uneri C, Sari M, Akboğa J, Yüksel M. Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane. Laryngoscope 2006; 116:140-3. [PMID: 16481827 DOI: 10.1097/01.mlg.0000191460.32862.bf] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Tympanosclerosis is a common sequela of ventilation tube treatment of otitis media with effusion causing hearing disability. It is associated with an increased production of free radicals (also known as reactive oxygen species) after myringotomy. Vitamin E is a scavenger of different free radicals by working as an antioxidant. The aim of the present study was to evaluate the effect of vitamin E-coated tympanostomy tube insertion at quantity of free radicals in rat tympanic membrane. METHODS This prospective, controlled animal study consisted of male Sprague-Dawley rats divided into two groups of 10 animals each. Ordinary silcone tubes were applied to the right ears of the first group and vitamin E-coated silcone tubes were applied to the right ears of the second group. The left ears were used as controls. Then, the animals were killed and chemiluminescence measurements were made for tympanic membranes. RESULTS Reactive oxygen species levels (ROS) were significantly increased in right ears of the first group when compared with the control ears (P < .0001), and the levels were statistically significant decreased in right ears of the second group as compared with the operated ears of the first group (P < .0001). The free radical levels of right and left ears in the second group were similar. CONCLUSIONS Our results indicate that vitamin E-coated tube insertion decreases the quantity of reactive oxygen species in tympanic membrane after myringotomy and tympanostomy tube insertion.
Collapse
Affiliation(s)
- Cüneyd Uneri
- Departments of Otorhinolaryngology, Head and Neck Surgery, Marmara University School of Medicine, Istanbul, Turkey.
| | | | | | | |
Collapse
|
36
|
Raustyte G, Cayé-Thomasen P, Hermansson A, Andersen H, Thomsen J. Calcium deposition and expression of bone modelling markers in the tympanic membrane following acute otitis media. Int J Pediatr Otorhinolaryngol 2006; 70:529-39. [PMID: 16159670 DOI: 10.1016/j.ijporl.2005.07.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2005] [Accepted: 07/30/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES In accordance with clinical findings, myringosclerosis develops after otitis media (OM) and paracentesis in an experimental setting. The pathogenesis of this phenomenon of calcification is poorly understood. As the calcification process and the sclerotic plaques of the drum mimics features of bone tissue, this study explores tympanic membrane calcium deposition in association with the expression of three bone modelling markers: osteopontin (OPN), osteoprotegerin (OPG) and osteonectin (ON). OPN is secreted by osteoblasts and is found at calcification sites, e.g. during pathological calcification in chronic OM. The cytokine OPG is an inhibitor of bone resorption and consequently bone remodelling. ON is a calcium binding glycoprotein necessary for the maintenance of bone mass and remodelling. It is found in bone matrix and synthesized by osteoblasts. METHOD A rat model of acute otitis media (AOM) caused by non-typeable Haemophilus influenzae was used. Four days following middle ear inoculation, a myringotomy was performed in six animals. Another group of ten animals was inoculated only. The drum was dissected in two animals from each group on day 4, 7, 14 and 28 post-inoculation, and the expression of OPN, OPG and ON was determined by immunohistochemistry. von Kossa staining determined the deposition of calcium and immune staining for CD68 identified macrophages. RESULTS Calcium depositions were initially accumulated in the cytoplasm of macrophages and dispersed in the connective tissue layers of the pars flaccida and tensa. Late accumulation occurred in the lamina propria of pars tensa, more extensively in myringotomized ears. OPN expression was found early in inflammatory cells including especially macrophages and late in pars tensa fibrocytes. OPG expression was initially located to inflammatory cells and late to pars tensa fibrocytes and the inner basal membrane of pars flaccida. Some ears displayed a marked pars flaccida expression of ON in the connective tissue matrix on early days and at the inner basal membrane on later days. The latter cases were from myringotomized ears. Otherwise, no apparent differences of marker expression occurred between myringotomized and non-myringotomized animals. CONCLUSION We conclude that osteopontin, osteoprotegerin and osteonectin are expressed by different cell types in the tympanic membrane during calcification in association with AOM, with or without myringotomy. These molecules may accordingly play a role in the pathogenesis of myringosclerosis, in which macrophages and fibrocytes appear as potential major players.
Collapse
Affiliation(s)
- Giedre Raustyte
- Department of Ear, Nose and Throat Diseases, Kaunas University of Medicine, Lithuania
| | | | | | | | | |
Collapse
|
37
|
Santos PF, Leal MC, Peixoto C, Caldas Neto S, Rosas STP. Achados otomicroscópicos e histológicos da miringoesclerose induzida em ratos: estudo crítico de um modelo experimental. ACTA ACUST UNITED AC 2005. [DOI: 10.1590/s0034-72992005000500019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A miringoesclerose é caracterizada por hialinização da lâmina própria da membrana timpânica. Trabalhos experimentais têm utilizado a otomicroscopia ou a histologia para estudar a miringoesclerose em animais, porém sem correlacionar precisamente estes dois métodos de avaliação. OBJETIVO: Este estudo procura avaliar a acurácia da otomicroscopia no diagnóstico de miringoesclerose em modelo experimental com ratos. FORMA DE ESTUDO: experimental. MATERIAL E MÉTODO: Foi induzida miringoesclerose por inoculação transtimpânica de Streptococcus pneumoniae em 25 ratos Wistar, que foram examinados quinzenalmente por otomicroscopia e sacrificados após oito semanas, tendo suas membranas timpânicas examinadas por histologia. RESULTADOS: Da confrontação das alterações otomicroscópicas com os achados histológicos, houve uma sensibilidade de 80% e especificidade de 75%. CONCLUSÃO: Pelos resultados obtidos neste estudo, a otomicroscopia não representou um bom método para avaliar a miringoesclerose neste modelo experimental.
Collapse
|
38
|
Cagdas KK. The role of experimental myringosclerosis in interpretation of tympanograms and its possible clinical implications. Med Hypotheses 2005; 64:1132-4. [PMID: 15823701 DOI: 10.1016/j.mehy.2004.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2004] [Accepted: 12/09/2004] [Indexed: 11/22/2022]
Abstract
Myringosclerosis (MS) is hyalinization and calcification of the collagen layer in certain areas of the tympanic membrane (TM) and appears as white chalky patches in otomicroscopy. One of the most common sequela from the use of grommets is the development of MS and its rate in the tubed ear ranges between 44% and 54% during long term follow-up. Among tympanometric configurations, type As tympanograms may indicate ossicular fixation, tympanosclerosis or otitis media with effusion. In case of multiple pathologies (e.g., MS and otitis media with effusion), it is not possible to evaluate the effect of a specific pathology in the absence of other, with otomicroscopy and tympanometry. We believe that the movement of TM is hampered by lesions of sclerotic material, thus resulting in decrease of amplitude in tympanograms without any effusion in middle ear. Now, we propose an experimental model specific for creating MS solely on TM and for performing tympanometric measurements on this pure MS model without creating any pathology in the middle ear, to test in what proportion this specific pathology contributes to decrease of amplitude in tympanograms. A myringotomy in rat's TM admits ambient air into the middle ear cavity, resulting in a relatively hyperoxic condition. The result of a myringotomy therefore is an increased production of free oxygen radicals, initiating irreversible tissue damage involving fibrosis, hyalin degeneration and finally apopitosis as observed in MS. After the closure of perforations, tympanometric measurements can be made on this pure MS model. When evaluating a child for suspected otitis media with effusion, the results of the experimental model might have far-reaching clinical implications and might provide suitable target for prevention of unnecessary myringotomies especially in the pediatric age-group.
Collapse
Affiliation(s)
- Kazikdas K Cagdas
- Department of Otolaryngology, Ataturk Training and Research Hospital, Izmir, Turkey.
| |
Collapse
|
39
|
Polat S, Oztürk O, Uneri C, Yüksel M, Haklar G, Bozkurt S, Küllü S. Determination of Reactive Oxygen Species in Myringotomized Tympanic Membranes: Effect of Vitamin E Treatment. Laryngoscope 2004; 114:720-5. [PMID: 15064630 DOI: 10.1097/00005537-200404000-00023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES/HYPOTHESIS Recent studies have established a strong relationship between the development of myringosclerosis and reactive oxygen species (ROS). The aims of the present study were to directly detect ROS in the tympanic membrane and middle ear mucosa of rats by measuring luminol amplified chemiluminescence, to evaluate the changes in the levels of ROS after treatment with vitamin E, and to examine the possible changes in the tympanic membranes otomicroscopically and histologically. STUDY DESIGN Prospective controlled animal study. METHODS Forty healthy Sprague-Dawley rats were divided into five groups of eight animals each. Animals in all groups except group 1 were bilaterally myringotomized. Group 2 received no treatment, group 3 was treated with topical olive oil, group 4 received topical vitamin E, and group 5 received intramuscular vitamin E. After 24 hours of myringotomy, tympanic membranes were examined otomicroscopically; thereafter, tympanic membranes and middle ear mucosa were peeled off. The right ears of the animals were used for biochemical assay, and the left ears were used for histological study. RESULTS Reactive oxygen species levels were significantly decreased in group 4 with topical application of vitamin E compared with untreated and myringotomized animals in group 2. Reactive oxygen species levels were also decreased in group 5, although the decrease was not statistically significant when compared with groups 2 and 3. Histological studies confirmed sclerotic changes in the untreated myringotomized animals. The tympanic membranes of animals in groups 2 and 3 showed a white, chalk-like pattern of sclerotic changes, whereas animals in groups 4 and 5, with the exception of two animals in group 5, lacked these changes. CONCLUSION Although the relationship between the development of myringosclerosis and ROS had been well documented previously, the present study is the first that has directly measured the levels of ROS in the tympanic membrane and middle ear mucosa. These results are relevant because they correlate with histological findings. It has also been demonstrated that topically applied vitamin E is effective in decreasing the ROS levels.
Collapse
Affiliation(s)
- Senol Polat
- Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University School of Medicine, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
40
|
Karlidağ T, Ilhan N, Kaygusuz I, Keleş E, Yalçin S. Comparison of Free Radicals and Antioxidant Enzymes in Chronic Otitis Media With and Without Tympanosclerosis. Laryngoscope 2004; 114:85-9. [PMID: 14710000 DOI: 10.1097/00005537-200401000-00014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE/HYPOTHESIS The pathogenesis of tympanosclerosis is unclear. The study was performed to investigate the role of nitric oxide, free oxygen radicals, and antioxidants in development of tympanosclerosis in patients with chronic otitis media. STUDY DESIGN A prospective study in patients with nasal polyps. METHODS Sixty-five patients who underwent tympanoplasty or tympanoplasty together with mastoidectomy were included in the study. Preoperative venous blood samples were drawn, and serum sodium, potassium, calcium, alkaline phosphatase, inorganic phosphorus, parathormone, and calcitonin levels were measured. The patients who had tympanosclerotic plaques on tympanic membrane or middle ear mucosa or near the ossicular chain or mastoid bone were designated as group 1 (n = 34), and the remaining patients as group 2 (n = 31). Intraoperatively, specimens were obtained from the middle ear mucosa and tympanic membrane to measure nitric oxide and malondialdehyde levels. In addition, plasma malondialdehyde levels and erythrocyte superoxide dismutase and catalase activity were determined. RESULTS All patients had similar demographic features and serum electrolyte and hormone levels. Nitric oxide and malondialdehyde levels of the specimens obtained from the middle ear mucosa (P =.001) and tympanic membrane (P =.01) and, in parallel to this, the plasma malondialdehyde activity level were higher in group 1 than in group 2. Moreover, group 2 had significantly lower erythrocyte catalase activity levels (P =.001) compared with group 1, whereas such a significant difference was not present for superoxide dismutase activity levels (P >.05). CONCLUSION The study results suggest that nitric oxide, free oxygen radicals, and catalase may have a role in the development of tympanosclerosis in patients with chronic otitis media.
Collapse
Affiliation(s)
- Turgut Karlidağ
- Department of Otorhinolaryngology, Medical Faculty, Firat University, Elaziğ, Turkey.
| | | | | | | | | |
Collapse
|
41
|
Abstract
There has been a recent surge in research on surfactant and surfactant proteins. Fields ranging from immunology to surface chemistry are making contributions to our understanding of this multifunctional compound. This paper reviews the literature on the structure and function of Eustachian tube surfactant. It covers the proposed functions of endogenous surfactant in normal physiology, as well as the experimental applications of exogenous surfactant in the treatment of otitis media. The analysis is based on four platforms of research: the role of surfactant in the innate immune system, the effect of surfactant on surface tension and Eustachian tube opening pressure, the capacity of surfactant to alter the rheological properties of mucus and the efficiency of the mucociliary system, and the ability of surfactant to mitigate oxygen free radical damage.
Collapse
Affiliation(s)
- John F McGuire
- School of Medicine, Georgetown University, 2908-B O Street NW, Washington, DC 20007, USA.
| |
Collapse
|
42
|
Spratley J, Hellström S, Eriksson PO, Pais-Clemente M. Myringotomy delays the tympanic membrane recovery in acute otitis media: a study in the rat model. Laryngoscope 2002; 112:1474-81. [PMID: 12172265 DOI: 10.1097/00005537-200208000-00027] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/HYPOTHESIS Acute otitis media is a major cause of visits to pediatric health care providers. Myringotomy in uncomplicated acute otitis media is debatable today. The study addressed this problem through the otomicroscopic and histopathological observations of the events occurring in the tympanic membrane during the first week after myringotomy. STUDY DESIGN Randomized study in an experimental animal model. METHODS Under anesthesia, the left middle ear of 36 Sprague-Dawley rats was inoculated with Streptococcus pneumoniae type 3. Forty-eight hours later, at day 0, four animals were immediately killed and the remaining animals were randomly assigned into a myringotomy group (n = 16, myringotomy on the left ear) and a non-myringotomy group (n = 16, otomicroscopy without myringotomy). Otomicroscopy and killings were performed in series of four animals from each group at days 1, 2, 4, and 7 after myringotomy. Tympanic membranes were collected after fixation and processed for light and electron microscopy. RESULTS All inoculated ears showed a manifest acute otitis media at day 0. An intense infiltration by inflammatory cells and edema distorted severely the tympanic membrane structure. These findings decreased the following days. However, inflammation as evaluated by the thickness and the cytoarchitecture of the tympanic membrane layers, recovered significantly faster in the membranes in the non-myringotomy group. At day 7, all tympanic membranes in the myringotomy group were closed by a hypertrophic keratinizing epithelium and a remodeling connective tissue layer, whereas the animals in the non-myringotomy group had a residual edema in the lamina propria. CONCLUSIONS The present infectious model induced an intense inflammatory reaction within the entire structure of the tympanic membrane. Myringotomy provoked a delayed recovery from the inflammatory process within the tympanic membrane. Therefore, if applicable to human conditions, the use of myringotomy in the management of acute otitis media should be restricted to selected cases of acute otitis media.
Collapse
Affiliation(s)
- Jorge Spratley
- Department of Clinical Sciences, Otorhinolaryngology, University Hospital of Northern Sweden, Umeå, Sweden.
| | | | | | | |
Collapse
|
43
|
Ozcan C, Görür K, Cinel L, Talas DU, Unal M, Cinel I. The inhibitory effect of topical N-acetylcysteine application on myringosclerosis in perforated rat tympanic membrane. Int J Pediatr Otorhinolaryngol 2002; 63:179-84. [PMID: 11997152 DOI: 10.1016/s0165-5876(01)00640-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Myringosclerosis often occurs in patients in whom ventilation tube insertion and tympanoplasty procedures are performed. Recent studies have revealed a relationship between the development of myringosclerosis and oxygen-derived free radicals, and some investigations have demonstrated that free radical scavengers prevent the development of myringosclerosis. N-acetylcysteine is a well-known anti-oxidant and anti-inflammatory agent. In this study, we aimed to investigate the preventive effect of N-acetylcysteine on myringosclerosis in myringotomized rat tympanic membranes. METHODS Twenty Sprague-Dawley rats were bilaterally myringotomized and divided into four groups. Group 1 received no treatment, group 2 was treated with topical saline solution in Spongostan, group 3 received topical 0.6 mg N-acetylcysteine in Spongostan and group 4 received 1.2 mg N-acetylcysteine in Spongostan daily for 12 days. Tympanic membranes were examined by otomicroscopy on day 12. Then, the membranes were harvested and evaluated histologically by light microscopy. RESULTS The tympanic membranes of groups 1 and 2 (saline and non-treated) showed extensive occurrence of myringosclerosis, whereas groups 3 and 4 (treated with N-acetylcysteine) showed lesser occurrence of myringosclerosis in otomicroscopic evaluation (P<0.01). Under light microscopic examination, lamina propria of pars tensa was found thicker in groups 3 and 4 when compared with groups 1 and 2. There was no significant difference between groups 3 and 4 (P: 0.30). CONCLUSIONS Topically applied N-acetylcysteine was found to be effective in the prevention of sclerotic lesions in myringotomized rat tympanic membranes.
Collapse
Affiliation(s)
- Cengiz Ozcan
- Department of Otorhinolaryngology, School of Medicine, Mersin University, Mersin, Turkey.
| | | | | | | | | | | |
Collapse
|
44
|
Ozcan C, Polat G, Görür K, Talas DU, Bağdatoğlu O, Cinel I. The effect of local administration of N-acetylcysteine in perforated rat tympanic membrane: an experimental study in myringosclerosis. Pharmacol Res 2002; 45:5-9. [PMID: 11820854 DOI: 10.1006/phrs.2001.0906] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Myringosclerosis (MyS) is a common sequela of acute and chronic otitis media and ventilation tube treatment of serous otitis media. We aimed to study the effect of topical administration of N -acetylcysteine (NAC) on MyS by assessment of otomicroscopic evaluation, lipid peroxidation and nitric oxide (NO) (nitrite/nitrate) levels in experimental myringotomized rat tympanic membrane. Thirty adult rats were used and the upper posterior quadrant of the tympanic membranes of rats was myringotomized. Thereafter, they were divided into four groups. Group I received no treatment, group II was treated with saline, groups III and IV were treated with topical NAC (0.1 ml of 6 and 12 mg ml(-1), respectively). The levels of nitrite/nitrate and malondialdehyde (MDA) were measured in serum samples. In the otomicroscopic evaluation, non-treated and saline treated ears (controls) showed extensive occurrence of myringosclerotic plaques. Groups III and IV showed fewer occurrences of sclerotic plaques. There was no significant difference between groups III and IV regarding the development of MyS. The development of myringosclerotic lesion was found to be significantly different between NAC treated groups (III and IV) and the control groups (I and II). The levels of nitrite/nitrate of both groups III and IV were significantly lower than the control groups. The levels of MDA of these groups were also significantly lower than the control group. The relationship between groups III and IV was not statistically significant for the levels of nitrite/nitrate and MDA. We conclude that the topical treatment of NAC reduces the levels of MDA and NO products in rats. These results suggest that topical NAC application may be useful for the prevention of MyS.
Collapse
Affiliation(s)
- Cengiz Ozcan
- Department of Otorhinolaryngology, Mersin University, School of Medicine, Mersin, Turkey.
| | | | | | | | | | | |
Collapse
|