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Cholesteatoma prevention by local treatment with vitamin A
B I Nageris1, I Grushko, R Feinmesser
1Department of Otolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Hypothesis:
In view of the proven effectiveness of vitamin A for the treatment of hyperkeratosis, it was hypothesized that vitamin A may also be a feasible therapeutic option for cholesteatoma, which has similar histologic features.
Background:
Cholesteatoma is a major cause of chronic ear disease, often requiring surgery. The recurrence rate may exceed 20%. Hyperkeratosis is a major sequela of tympanomastoid surgery, causing chronic ear hygiene problems.
Methods:
The external auditory canals of 40 Mongolian gerbils were ligated to induce cholesteatomas. The ears were divided into three groups by type of treatment: group I, vitamin A drops (n = 40); group II, Cortisporin drops (n = 20); group III, no treatment (control subjects) (n = 20). Examination for the development and grade of cholesteatomas was performed after 9 months.
Results:
Cholesteatomas developed in 26 ears (65%) of group I, 12 ears (60%) of group II, and 20 ears (100%) of group III. The differences were significant between groups I and III and groups II and III for both rate of cholesteatomas and severity of grade. There were no significant differences between groups I and II.
Conclusion:
Local treatment reduces the risk of cholesteatomas in ligated gerbilline ears. Cortisporin and vitamin A are equally effective as local treatments.