| Objective:To investigate the role of interleukin-6(IL-6)and tumor necrosis factor-?(TNF-?)in the cholesteatoma epithelium in the development and progression of cholesteatoma in patients with middle ear cholesteatoma,and to investigate the correlations between IL-6,TNF-?expression levels in cholesteatoma epithelium as well as hearing loss in patients with middle ear cholesteatoma.Methods:We collected 89 patients with otitis media(including 68 patients with middle ear cholesteatoma and 21 patients with the active period of chronic suppurative otitis media)who were treated at the Department of Otolaryngology of People's Hospital of Xinjiang Uygur Autonomous Region and they were surgically treated from January 2017 to January2020.All patients underwent a pure-tone hearing threshold examination to evaluate hearing loss.The IL-6 and TNF-?expression in 18 patients with middle ear cholesteatoma were detected by enzyme-linked immunosorbent assay(ELISA).The expression levels of IL-6and TNF-?in cholesteatoma epithelium,as well as their correlation were analyzed.Another6 patients with the active period of chronic suppurative otitis media were selected as the control group to detect the above inflammatory factors for the same method.Results:1.Among the 89 patients with otitis media,there were 30 males and 38 females,aged 8-80 years old,with an average age of(38.53±17.76)years in cholesteatoma group; there were 8 males and 13 females,aged 13-58 years,with an average age of(42.38±12.25)years in the the active period of chronic suppurative otitis media group.The significant differences in the parameters of the pure-tone hearing threshold between the middle ear cholesteatoma group and the control group were as follows:the air conduction threshold(AC)average of 21 patients with the active period of chronic suppurative otitis media was57.80±13.72 dBHL,and that in 68 patients with middle ear cholesteatoma was 69.76±21.54 dBHL,t=-3.011,P=0.004;the bone conduction hearing threshold(BC)average in21 patients with the active period of chronic suppurative otitis media was 32.14±12.02 dBHL,and that in 68 patients with middle ear cholesteatoma was 39.38±16.20 dBHL,t=-1.889,P=0.062;the bone air conduction gap(ABG)of 21 patients with the active period of chronic suppurative otitis media was 25.65±9.28 dBHL,and that of 68 patients with middle ear cholesteatoma was 30.39±9.24 dBHL,t=-2.048,P=0.044.2.The IL-6 and TNF-?expressions in 18 patients with middle ear cholesteatoma and 6patients with the active period of chronic suppurative otitis media were detected by ELISA.The expression levels were:IL-6:0.98±0.44 ng/l,1.52±0.61 ng/l,t=2.220,P<0.05;TNF-?:18.64±8.55 ng/l,28.29±5.64 ng/l,t=2.354,P<0.05.It was obvious that there were significant differences between the expression levels of IL-6 and TNF-?in patients with middle ear cholesteatoma and the active period of chronic suppurative otitis media.3.In the cholesteatoma epithelium of 18 patients with middle ear cholesteatoma,the expression levels of TNF-?were positively correlated with the pure-tone hearing threshold(r_sAC=0.654,P<0.05;r_sBC=0.526,P<0.05;r_s ABG=0.678,P<0.05).But there was no significant correlation between the expression level of IL-6 and the pure tone hearing threshold(r_sAC=0.367,P>0.05;r_sBC=0.316,P>0.05;r_sABG=0.289,P>0.05).4.There was a linearly positive correlation between the expression levels of IL-6 and TNF-?in the cholesteatoma epithelium of 18 patients with middle ear cholesteatoma.Conclusion:1.There was a positive correlation between the high expression of TNF-?in middle ear cholesteatoma epithelium and the patient's hearing loss,namely that with the TNF-?concentration increased,the patient's hearing loss got more severe.2.There was no significant linear correlation between IL-6 concentration in middle ear cholesteatoma epithelium and hearing loss in the middle ear cholesteatoma patients.3.There was a positive correlation between TNF-?concentration and IL-6concentration in the middle ear cholesteatoma epithelium. |
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