Effect of Tacrolimus on Development of Experimental Cholesteatoma

Cholesteatoma is a benign yet aggressive middle ear tumor characterized by keratin accumulation and chronic inflammation, leading to bone resorption and severe complications. This study aimed to investigate the effects of Tacrolimus, a potent immunosuppressive agent, on cholesteatoma formation in a propylene glycol (PG)-induced experimental model.

Fifteen male Wistar Albino rats were used, with right ears serving as controls and left ears as the experimental group. Cholesteatoma was induced by injecting 60 % PG combined with Gentamicin and Saline into the middle ear. The experimental group received the same solution supplemented with Tacrolimus. Histological evaluation included keratinization, inflammation, fibrosis, and vascular proliferation. Statistical analysis was performed to compare the control and experimental groups.

Experimental cholesteatoma formation was achieved in 80 % of ears injected with PG (12 out of 15 ears). In the Tacrolimus-treated group, cholesteatoma formation was observed in only 1 ear (6.7 %), while the remaining 14 ears showed no evidence of keratin lamellae (p < 0.05). Although Tacrolimus significantly inhibited epithelial keratinization and invagination, no significant differences were found between groups regarding acute or chronic inflammation, fibrosis, or vascular proliferation (p > 0.05).

Tacrolimus demonstrated a strong inhibitory effect on cholesteatoma formation in this experimental model by markedly reducing epithelial keratinization and invagination. These findings suggest Tacrolimus's potential as a novel therapeutic agent for cholesteatoma. However, further studies are required to assess its safety, long-term efficacy, and clinical applicability.