Changes in Coagulation Study and Risk of Developing Cholesteatoma: Is There a Link?

Abstract

Background and Objectives: The etiopathogenesis of acquired pediatric cholesteatoma has not yet been fully clarified. Recent studies and modern technologies have led researchers to look for explanations at a molecular level. This study aims to understand if the origins of cholesteatoma could be related to dysfunctions in coagulation factors, thereby emphasizing its role in angiogenesis.Subjects and Methods: This was a retrospective case-control study carried out at a tertiary hospital center between January 2010 and December 2020. The study included 92 children. The variables of the summary coagulation study (partial thromboplastin time, prothrombin time, and international normalized ratio) were compared among children with and without development of chronic otitis media with cholesteatoma.Results: The cases and controls were comparable in terms of age, type, and number of times that ventilation tubes were placed. Partial thromboplastin times tended to be higher in children who developed cholesteatoma, with a statistically significant difference between the two groups in terms of normal and abnormal partial thromboplastin times (<i>p</i>=0.029).Conclusions: The results of this case control study indicate that slight extension of partial thromboplastin times in the coagulation study may not meet the criteria for diagnosis of certain hematological pathologies or clinical significance, but at a molecular level may already have implications for activation of angiogenesis and other growth factors involved in the onset, growth, and expansion of acquired pediatric cholesteatoma.

Expression and Regulatory Mechanisms of MicroRNA in Cholesteatoma: A Systematic Review

“…The presence and distribution of blood vessels in cholesteatoma were investigated and revealed the presence of increased vascularization in the subepithelial connective tissue of cholesteatoma (perimatrix), which probably plays a role in maintaining continued abnormal growth [54][55][56]. Analysis of the angiogenic growth factors in middle ear cholesteatoma revealed their altered expression compared to middle ear mucosa or auditory meatal skin [55,[57][58][59][60][61][62][63]. Therefore, the possibility of using antiangiogenic molecules in the adjuvant treatment of cholesteatoma surgery has been proposed [62].…”