Publication details
Histologická a histochemická analýza retrakční kapsy pars tensa ušního bubínku u dětí
| Title in English | Histological and Histochemical Analysis of Retraction Pocket Pars Tensa of Tympanic Membrane in Children |
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| Authors | |
| Year of publication | 2017 |
| Type | Article in Periodical |
| Magazine / Source | Otorinolaryngologie a foniatrie |
| MU Faculty or unit | |
| Citation | |
| Field | ORL, ophthalmology, stomatology |
| Keywords | retraction pockets; histological analysis; cholesteatoma; children |
| Description | Aims: Histological and histochemical analysis of retraction pocket of pars tensa of tympanic membrane in children. Identification of morphological abnormalities in comparison with a healthy tympanic membrane was investigated as well as identification of signs typical for cholesteatoma and support for a retraction theory of cholesteatoma formation. Study design: A prospective study analyzing 31 samples of retraction pockets taken during surgery. Departments: University Hospital, Children’s Medical Centre. Methods: Samples of retraction pockets were processed by a standard process for light microscopy, stained by hematoxilin-eosin. Van Gieson’s stain was used for differential staining of collagen, Verhoeff’s stain for elastic fiber tissues, Alcian blue for acidic polysaccharides and PAS (Periodic Acid Schiff) method for basement membrane polysaccharides. Results: The following findings were observed in the samples of retraction pockets: 1 hyperkeratosis (100 %), 2 hypervascularisations (100 %), 3 subepithelial fragmented elastic fibres (96 %), 4 myxoid changes (87 %), 5 subepithelial inflammatory infiltration (84 %) 6 rete pegs (71 %), 7 papillomatosis (71 %) 8 intraepithelial inflammatory cellularizations (48 %), 9 intraepithelial spongiosis (16 %) and 10 parakeratosis (3 %). No basement membrane continuity interruptions were observed. Length and thickness of retraction pocket, thickness of epidermis, occurrence of rete pegs and frequency of fragmented elastic fibres was higher in a grade III than grade II (according to Charachon). Conclusion: Morphological abnormalities in the structure of retraction pockets in comparison with a healthy tympanic membrane were described. The changes are typical for a structure of cholesteatoma, supporting retraction theory of its origin. Our observations show that it is inflammation that plays a key role in the pathogenesis of retraction pocket. The frequency of some of the changes increases with the stage of retraction pocket (II-III according to Charachon). Basement membrane continuity interruptions are not typical for retraction pockets. |
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