Expression of Human Papilloma Virus DNA in Middle Ear Cholesteatoma

Basic research in chronic otitis media with cholesteatoma is very important as it may clarify the pathophysiology of the disease and explain the wide variation in clinical course. In the present study aggressive type cholesteatoma has histopathological findings characteristic of human papilloma virus induced-lesions (i.e. obvious koilocytosis) in 33.3% specimens. Moreover 50% of the aggressive cholesteatoma were stained positive for human papilloma virus (HPV) polymerase chain reaction (PCR). Statistical correlations were established between hyperproliferation (as revealed by MIB 1 high score) of the cholesteatoma and severe bone erosion (pave the way to major cholesteatoma complications) and also between hyperproliferation and middle ear inflammation (associated with more surgical difficulties and possible higher risk of recurrences). These findings indicate a possible relationship between HPV with more aggressive cholesteatoma. It may arouse the cleavage, proliferation of cholesteatomatous epithelium and may also play a certain role in the recurrence of the disease following well performed surgical excision.