Aural Cholesteatoma: Role of Tumor Necrosis Factor-Alpha in Bone Destruction

Abstract

Introduction: This study was undertaken to define the role of tumor necrosis factor-alpha (TNF-alpha) in bone destruction associated with aural cholesteatoma. An attempt was made to show a correlation between TNF-alpha levels and cholesteatoma-associated bone destruction by localizing TNF-alpha in cholesteatoma and measuring its serum level. Methods: Serum TNF-alpha levels were measured in 20 patients with cholesteatoma of the temporal bone and histochemical staining was used to localize TNF-alpha in pathologic tissue excised at surgery. Results: Serum TNF-alpha levels in cholesteatoma patients were significantly higher than in controls. In addition, TNF-alpha levels in patients with bone destruction were higher than in those without bone destruction. However, there was no correlation between age of patient and serum TNF-alpha levels. The TNF-alpha was localized in various layers of cholesteatoma epithelium using indirect immunoperoxidase staining. Conclusion: TNF-alpha is one of the cytokines produced by cholesteatoma that may be an important mediator of bone destruction associated with cholesteatoma. TNF-alpha has been localized in various layers of cholesteatoma and exerts a locally destructive effect on bone. Serum TNF-alpha levels are related to extent of bone destruction.