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Candida and stapedial otosclerosis: histopathological findings
A Quaranta1, R Bartoli, L Resta
1ENT Department, University of Bari, Italy.
Abstract:
The stapes of 6 patients with stapedial otosclerosis was found to contain fungus hyphae (Candida) in the sectioned specimens. The footplate of all cases and the head of the stapes in 2 of the cases revealed single or multiple erosion cavities containing numerous thin branching PAS-positive fungus hyphae with swollen terminal endings and scanty blastospores. Osteoclasts were not observed; occasional osteoblasts, blue mantles and otosclerotic foci were seen. Four patients had been treated for several years with antibiotics and corticosteroids for recurrent serous otitis media and 1 patient had had frequent catheterization of the eustachian tube. It may be suggested that the Candida infection was a secondary event induced by a general and/or local immunodepressed condition.
Insights
Fungal hyphae (Candida) were discovered in the stapes of patients with stapedial otosclerosis. This Candida infection may be secondary to an immunodepressed state, possibly linked to prior treatments or medical procedures.
Area of Science:
- Otolaryngology
- Mycology
- Pathology
Background:
- Stapedial otosclerosis is a condition affecting the stapes bone.
- Fungal infections can occur in various tissues, but their role in otosclerosis is not well-established.
Purpose of the Study:
- To investigate the presence and characteristics of fungal elements in the stapes of patients diagnosed with stapedial otosclerosis.
Main Methods:
- Histopathological examination of sectioned stapes specimens from patients with stapedial otosclerosis.
- Identification of fungal hyphae using Periodic Acid-Schiff (PAS) staining.
- Correlation of findings with patient medical history, including treatments for serous otitis media and eustachian tube catheterization.
Main Results:
- Fungus hyphae, identified as Candida, were present in the stapes of all 6 patients studied.
- Erosion cavities containing Candida hyphae and blastospores were observed in the footplate and, in some cases, the stapes head.
- Absence of osteoclasts, with presence of osteoblasts and otosclerotic foci, was noted. No significant inflammatory response was detailed.
Conclusions:
- Candida infection may be a secondary event in stapedial otosclerosis.
- The findings suggest a potential link between immunodepression (due to prior treatments or procedures) and secondary fungal colonization of the stapes.
- Further research is warranted to elucidate the role of fungal infections in the pathogenesis of otosclerosis.