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Lipopolysaccharide Concentration and Bone Resorption in Cholesteatoma

Peek, F. A. W.*; Huisman, M. A.*; Berckmans, R. J.; Sturk, A.; van Loon, J.; Grote, J. J.*

MIDDLE EAR & MASTOID DISEASE
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Hypothesis There is a relationship between the local lipopolysaccharide (LPS) concentration in cholesteatoma and local bone resorption in chronic otitis media (COM) with cholesteatoma.

Background During the past decade, it has become known that the recruitment of osteoclasts is the main causative factor that induces bone destruction in COM with cholesteatoma. Cellular inflammation factors like cytokines may trigger the osteoclast. Sequel to this, LPS is able to up-regulate cytokines. This makes it of interest to study whether the local LPS concentration is related to bone resorption in cholesteatoma.

Materials and Methods Twenty-four cholesteatoma samples and control tissue from COM patients without cholesteatoma were collected. During surgery, the degree of bone resorption was established and classified. Retrospectively, the authors checked whether patients had chronic purulent otorrhea. LPS concentration of the tissue samples was measured by the limulus amebocyte lysate test. The one-way analysis of variance test was used to determine the relation between LPS concentration, otorrhea, and local bone resorption.

Results A significantly higher concentration of LPS was measured in samples from patients with cholesteatoma with bone resorption and otorrhea compared with cholesteatoma without bone resorption and control tissue. There were no significant differences between the LPS levels of the different groups of patients with bone resorption.

Conclusion It is suggested that LPS is one of the first factors in the cascade of bone resorption in COM with cholesteatoma.

Department of *Otorhinolaryngology Head & Neck Surgery, Leiden, The Netherlands; †Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands; and ‡Department of Clinical Chemistry, Leiden University Medical Center, Leiden, The Netherlands.

Address correspondence and reprint requests to Dr. F. A. W. Peek, ENT Department, Room J2-77, Building 1, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.

© 2003 Otology & Neurotology, Inc.