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A Study of Inflammatory Mediators in the Human Tympanosclerotic Middle Ear
Marie Forséni, MD, PhD;
Dan Bagger-Sjöbäck, MD, PhD;
Malou Hultcrantz, MD, PhD
Arch Otolaryngol Head Neck Surg. 2001;127:559-564.
Objective To analyze immunocompetent cells as well as 2 factors involved in inflammation
and also thought to be involved in bone remodeling—interleukin 6 (IL-6)
and inducible nitric oxide synthase in the human middle ear, including the
tympanic membrane.
Design Biopsy specimens were obtained from the human middle ear and tympanic
membrane during surgery. Using an immunohistochemical technique, the expression
of macrophages, T cells, B cells, IL-6, and inducible nitric oxide synthase
were analyzed.
Materials Nine biopsy specimens from tympanic membranes in children having a transtympanic
ventilation tube inserted as a treatment for secretory otitis media and 11
biopsy specimens from tympanosclerotic plaques from patients with chronic
otitis media and tympanosclerosis.
Results More positively stained specimens showing macrophages, B cells, and
IL-6 were seen in the biopsy specimens from children with secretory otitis
media compared with the biopsy specimens from patients with chronic otitis
media and tympanosclerosis. The biopsy specimens from patients with chronic
otitis media and tympanosclerosis more often showed positive stainings for
inducible nitric oxide synthase than the biopsy specimens from children with
secretory otitis media. The presence of IL-6 and inducible nitric oxide synthase
was shown by staining to be mostly in the surface cells, while macrophages
and B cells were stained deeper in the tissues, in connective tissue, or around
sclerotic lesions.
Conclusions The 2 patient groups differed in antigen presentation so that macrophages,
B cells, and IL-6 were labeled more frequently in patients with secretory
otitis media, that is, an early phase of the disease. Inducible nitric oxide
synthase was seen more frequently in the patients with already established
tympanosclerosis in a later phase of the disease.
From the Departments of Otorhinolaryngology, Karolinska Institute and
Hospital, Stockholm, Sweden.
Corresponding author and reprints: Marie Forséni, MD, PhD,
Department of Plastic and Reconstructive Surgery, Karolinska Hospital, 171
76 Stockholm, Sweden (e-mail: marie.forseni{at}ood.ki.se)
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