Toll-like receptor 2 (TLR2) plays a key role in the host defense against Gram staining positive (Gram ϩ ) bacteria and their cell wall envelope components. However, little is known about the expression of TLR2 in the middle ear under otitis media (OM) conditions, and its role in the persistent otitis media with effusion (OME). In this study, we demonstrated that the pneumococcal cell wall component, peptidoglycan-polysaccharides (PGPS), activated the expression of TLR2 in the middle ear epithelial cells through the nuclear factor kappa B (NF-B)-cytokine signaling pathway while I kappa B alpha mutant (IB␣M), a dominant negative inhibitor of NF-B, abrogated the expression of TLR2 induced by PGPS. This study suggests that the existence of residual PGPS may maintain a low profile of cytokine production in the middle ear mucosa and thus contribute to the pathogenesis of OME. (Pediatr Res 69: 101-105, 2011)

A hallmark of cholesteatoma is hyperproliferation of keratinocytes with abundant production of keratins in the middle ear under chronic inflammatory conditions. We demonstrated in this study that Id1, an inhibitor of DNA-binding protein, is involved in the hyperproliferation of keratinocytes, positively via the nuclear factor-kappa B (NF-κB)/cyclin D1 pathway which is linked to cell cycle progression and negatively via the p16 Ink4a which is linked to cell cycle inhibition. Id1 significantly increased the transcription of NF-κB which, in turn, upregulated the expression of cyclin D1 and keratin 10 in keratinocytes. Specific NF-κB inhibitors (pyrrolidine dithiocarbamate, PDTC), or dominant-negative inhibitor (I kappa B alpha mutant, IκBαM) abrogated the Id1-induced cell proliferation and keratin 10 production whereas p65, a subunit of the NF-κB heterodimer and an enhancer of the NF-κB activity strengthened the Id1-induced cell proliferation and keratin 10 production. It was concluded that Id1 contributed to hyperproliferation of keratinocytes via enhancement of cell cycle progression and removal of cell cycle inhibition and simultaneously increased keratin production.

Background Cartilage conduction hearing aids (CCHAs) were newly devised and spread fast in Japan since their launch in 2017. However, little knowledge is available for this new device. Purpose The aim of this study was to establish the knowledge of CCHAs and suggest their indication. Research Design Correlational study. Study Sample A total 256 patients were registered. Data Collection and Analysis The fitting of CCHAs was surveyed in nine institutions. The outcomes were assessed by audiometric tests. The patients were classified into seven groups, depending on the ear conditions. The clinical characteristics, assessment results, and purchase rates were compared among the groups. The assessment results of CCHAs were also compared with those of previously used hearing aids. Results Most patients who used CCHAs were classified into the bilateral closed (aural atresia or severe stenosis) ear (n = 65) or unilateral closed ear (n = 124) groups. The patients in these groups achieved good benefits that resulted in a high purchase rate. The bilateral continuous otorrhea group also supported a high purchase rate, although the benefits of CCHAs were not always excellent. In contrast, the purchase rate was poor in the patients who could use air conduction hearing aids (ACHAs) without absolute problems. As for using a CCHA as a contralateral routing of signals hearing aid, the benefits depended on the patients. Conclusions CCHAs are considered as a great option not only to the patients with closed ears but also to those who had difficulties in ACHAs usage.

Although the follow-up period and number of patients were limited, early-stage CC can be safely removed using TEES.