Osteoclastic activity in chronic otitis media with cholesteatoma-related bone destruction

Abstract

Background Cholesteatoma-related bone destruction is the cause of many complications due to chronic otitis media. This study aimed to evaluate osteoclastic activity in cholesteatoma-related bone destruction using tartrate-resistant acid phosphatase 5b, an enzyme specific to osteoclastic activity. Method Seventy-two patients diagnosed with chronic otitis media were included in this study and were divided into two groups: with and without bone destruction. The blood serum and tissue tartrate-resistant acid phosphatase 5b levels from both groups were compared. Results There were no significant differences in the level of serum enzymes between both groups. However, in tissue samples, tartrate-resistant acid phosphatase 5b levels were significantly lower in the bone destruction group than the group without bone destruction. Conclusion This study determined that the level of tartrate-resistant acid phosphatase 5b, a specific enzyme for osteoclastic activity in cholesteatoma-related bone destruction, is locally decreased. This data suggests that osteoclastic activity may decrease in cholesteatoma-related bone destruction. However, further experimental and clinical studies are required to clarify this highly complex mechanism.

Bone destruction in chronic otitis media is not mediated by the RANKL pathway or estrogen receptor-alpha

“…Multiple studies have shown that bone destruction in cholesteatoma is mediated by the RANKL pathway. 3,4,23 Conversely, some studies have revealed potential mechanisms of bone resorption in cholesteatoma that are independent of the RANKL pathway or osteoclast activation 24,25 ; the results of the present study were consistent with those findings. Notably, estrogen plays an osteoprotective role in osteoporosis by regulating the RANKL pathway.…”