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Histological analysis of retraction pocket pars tensa of tympanic membrane in children

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URÍK Milan HURNÍK Pavel ŽIAK D. MACHAČ Josef ŠLAPÁK Ivo MOTYKA O. VACULOVÁ J. DVOŘÁČKOVÁ J.

Rok publikování 2016
Druh Článek v odborném periodiku
Časopis / Zdroj International journal of pediatric otorhinolaryngology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Obor ORL, oftalmologie, stomatologie
Klíčová slova Retraction pockets; Histological analysis; Cholesteatoma; Children
Popis 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 as it is described in standard textbook. Identification of signs typical for cholesteatoma and support for a retraction theory of cholesteatoma formation. Study design: A prospective study analysing 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 haematoxylin-eosin. Van Gieson's stain was used for differential staining of collagen, Verhoeff's stain for elastic fibre 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: hyperkeratosis (100%), hypervascularisations (100%), subepithelial fragmented elastic fibres (96%), myxoid changes (87%), sub epithelial inflammatory infiltration (84%), rete pegs (71%), papilomatosis (71%), intraepithelial inflammatory cellularizations, (48%), intraepithelial spongiosis (16%) and parakeratosis (3%). No basement membrane continuity interruptions were observed. Thickness of retraction pocket, thickness of epidermis, occurrence of rete pegs and frequency of fragmented elastic fibres was higher in a Grade III stage RP than Grade II stage RP (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 (these changes are common in matrix and perimatrix), supporting retraction theory of its origin. Our observations show that it is inflammation that probably plays a key role in the pathogenesis of retraction pocket. The frequency of some of the changes increases with the stage of retraction pocket according to Charachon). Basement membrane continuity interruptions are not typical for retraction pockets.
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