|
Fibroblast growth
factor receptor expression in aural polyps: predictor of
cholesteatoma? J Laryngol Otol. 2004 May;118(5):338-42.
The
cytokine, fibroblast growth factor (FGF) and its receptors (FGFR)
have a pivotal role in wound repair and have been demonstrated in
the perimatrix of active cholesteatoma. Aural polyps are a
recognized inflammatory reaction of middle-ear mucosa to
cholesteatoma, but may arise in its absence. This study examines 28
archival aural polyp specimens, seeking an increased expression for
FGFR1 and FGFR3 in polyps associated with cholesteatoma, when
compared with those arising in non-cholesteatomatous, mucosal
disease, but produced a null result. There was no difference
demonstrated in staining intensity between those polyps associated
with cholesteatoma and those without. There was a strong correlation
between staining patterns of FGFR1 and FGFR3 (r = 0.4, p <0.03).
The expression pattern, of nuclear and perinuclear localization, may
support the view that nuclear translocation of growth factors, and
their receptors, could be related to the cellular proliferation that
is associated with cholesteatoma.
Aural polyp in
chronic inflammatory middle ear disease. Acta Oto rrinolaringol
Esp.2003 Mar;54(3):161-4.
240
patients with chronic otitis media (COM) were studied: 166 ears
termed as non cholesteatomatous otitis media and 74 with
cholesteatoma. In 38 ears an aural polyp was found with no evidence
of cholesteatoma in 19 ears (11.4%) whereas a cholesteatoma was
present in the remaining 19 ears. The histology of the polyp and the
characteristics of the chronic process were matched: a) The aural
polyp is an infrequent complication in COM. b) After
histological analysis was found to present two different pictures:
The inflammatory reaction polyp, present in non cholesteatomatous
COM; and the polyp with granulation tissue and foreign body reaction
(keratina) usually found in cholesteatomatous COM. c) The finding of
granulation tissue reaction and keratina in an aural polyp is a good
predictor for the presence of a cholesteatoma.
Aural polyps:
safe or unsafe disease? Am J Otolaryngol. 2003 May-Jun;24(3):155-8.
PURPOSE: To
determine whether a case of inflammatory aural polyp constitutes a
safe or unsafe disease and to arrive at the most suitable treatment
option. DESIGN: Prospective study. Follow-up period of 6 months.
SETTING: Hospitalized treatment in a tertiary medical college
hospital that provides care for a predominantly rural population.
PATIENTS: All patients treated for aural polyp, having a
postoperative histopathological diagnosis of inflammatory aural
polyp. Most patients (72%) belonged to the lower middle class.
RESULTS: Forty-two patients treated during a 4-year-period were
analyzed. Eleven cases were treated by simple aural polypectomy, of
which 78% had either recurrence or persistent disease. Out of 31
patients who underwent mastoid exploration, 52% had extensive
disease of the mastoid air-cell system and 35% had an underlying
cholesteatoma. Six percent had persistent discharge. The disease was
often associated with complications (19%). CONCLUSIONS: The presence
of an aural polyp signifies well-established disease of the middle
ear cleft with a greater potential for complications and often
obscures an underlying cholesteatoma. We propose that all cases of
aural polyps should be considered as unsafe disease and subjected to
a formal mastoid exploration.
Mast cells in
aural polyps: a preliminary report. J Laryngol Otol.1995
Jun;109(6):491-4.
Mast cells
are a rich source of potent biologically active mediators and are
found in connective tissue, associated with blood vessels in many
varied inflammatory conditions. Mast cells have been described in
nasal polyps and turbinates and in adenoidal tissue in the upper
aerodigestive tract. As the middle ear lining is contiguous with the
nose and the nasopharynx, the presence of mast cells in aural polyps
is interesting. This preliminary study investigated the presence of
mast cells in inflammatory aural polyps using light microscopy. All
patients presenting to the department in one year were included.
Patients with previous ear disease or surgery and in whom
cholesteatoma was suspected were excluded. Except for one patient
mast cells were seen in all aural polyps. The implications of these
findings is discussed. Further work is needed using electron
microscopy.
Management of the
inflammatory aural polyp. J Laryngol Otol.1989 Nov;103(11):1040-2.
Investigation
into the underlying disease causing an aural polyp is often hampered
when the polyp itself obscures the tympanic membrane. This
retrospective analysis of 65 patients undergoing aural polypectomy
was carried out to identify any predictive factors for underlying
cholesteatoma and to determine a correct management strategy for
aural polyps. The duration of symptoms, size of polyp, size of
conductive component of hearing loss and bacteriology of otorrhoea
were unhelpful as predictors of the underlying disease. Radiological
evidence of bony erosion of the mastoid is a useful sign of
cholesteatoma when present. Aural polypectomy resulted in 58.3 per
cent of ears becoming inactive. It is proposed that aural
polypectomy and histological assessment should be employed as
initial treatment with mastoid exploration reserved for those ears
thus identified as high risk for cholesteatoma.
Aural polypi: a
histopathological and histochemical study. ORL
J Otorhinolaryngol Relat Spec. 1982;44(2):108-15.
Aural
polypi associated with chronic suppurative otitis media have been
studied histopathologically and histochemically in 20 patients. The
polypi consist of an edematous connective tissue stroma infiltrated
by chronic inflammatory cells and numerous blood vessels. The
surface is covered by intact stratified squamous epithelium. The
histochemical study revealed altered permeability of the blood
vessels which seem to be the main pathological background for polyp
formation. An enhanced phagocytic activity and increased metabolic
activity were found in the epithelium in the chronic inflammatory
cells. No glandular activity was found in the polypi.
|
