Expression of Angiogenic Growth Factor in Middle Ear Cholesteatoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Angiogenesis is important both in normal and pathologic processes, including wound healing and inflammation. Because proliferating tissues require an enhanced blood supply, angiogenesis appears to be a prerequisite for expansion of cholesteatoma. This study was aimed to investigate mRNA and protein expression of angiogenic growth factors such as vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor-alpha (TGF-alpha) and platelet derived-endothelial cell growth factor (PD-ECGF) in middle ear cholesteatoma. SUBJECTS AND METHOD: Cholesteatoma tissues and retroauricular skins were obtained from 12 patients during operation. The mRNA expression was detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the degree of expression was measured by comparing density ratio of beta-actin by NIH imaging analysis system. The protein expression was evaluated by immunohistochemistry, and the degrees of expression in epithelial, endothelial, inflammatory cells of cholesteatoma and retroauricular skin were judged by two pathologists and then converted on a 5-grade rating scale according to intensity of expression. RESULTS: The expression rate of mRNA in cholesteatoma and retroauricular skin was 67.7 and 33.3% in VEGF, 75.0 and 50.0% in bFGF, 53.8 and 8.3% in TGF-alpha, 67.7 and 75% in PD-ECGF. There was statistically significant difference only in TGF-alpha (p0.05). The degrees of VEGF, bFGF and PD-ECGF protein expression in cholesteatoma tissue were more intense at the inflammatory (p0.05) than in retroauricular skin. And the degree of TGF-alpha protein expression in cholesteatoma tissue was more intense at all three cells (p<0.05) than in the retroauricular skin. CONCLUSION: These results suggest that angiogenesis processes in cholesteatoma perimatrix and the expression of angiogenic growth factors are upregulated by mRNA. Further studies for evaluating the factors that can affect the expression of mRNA and also for disclosing the roles and control mechanisms of these factors in cholesteatoma angiogenesis must be followed.

A Case of Concurrent Mature Teratoma and Heterotopic Gastrointestinal Cyst in Head and Neck / 대한이비인후과학회지

Teratoma is a congenital tumor which occurs rarely in the head and neck. Head and neck teratomas have been described infrequently in the literature as a result of their low incidence, occuring in only 1 in 20, 000 to 40, 000 live births. And the heterotopic gastrointestinal cyst, a type of choristoma, is uncommon in head and neck also. Patients with these tumors have symptoms related to difficulties with swallowing and respiration that could result in high degree of morbidity and mortality by virtue of size and location of tumor. The purpose of this paper is to report a case of neonate who had mature teratoma of nasopharynx and a heterotopic gastrointestinal cyst of left submandibular gland. We review the literature pertaining to teratoma and heterotopic gastrointestinal cyst in head and neck.

A Case of Cerebellopontine Angle Lipoma Presented as Sudden Hearing Loss / 대한이비인후과학회지

Intracranial lipomas are uncommon and rarely symptomatic benign tumors comprising 0.1% of intracranial tumors. Although they can be found in other sites of the brain, the corpus callosum is generally believed to be the most common location of these tumors. And lipomas within the cerebellopontine (C-P) angle and internal auditory canal are extremely rare. In the C-P angle region, lipomas are the most symptomatic compared in other intracranial regions, although symptoms depend on the origin site and involve neural and vascular tissues adjacent to lipomas. And hearing loss, dizziness and tinnitus are the commonly presenting symptoms. Among these symptoms, hearing loss is the most common, but sudden hearing loss, as in this case, has not been reported. Because of the potential for significant morbidity with surgical resection of these lesions, conservative follow-up is the best treatment option for patients with these rare lesion. But surgery is indicated only when significant progressive or disabling symptoms are present. We experienced a case of right side C-P angle lipoma with sudden hearing loss in a 49-year old female who showed complete recovery of hearing by conservative therapy. With a review of literature, authors report a case of right C-P angle lipoma presented as sudden hearing loss.