Chole R A
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis.
Ann Otol Rhinol Laryngol. 1988 Nov-Dec;97(6 Pt 1):661-6. doi: 10.1177/000348948809700615.
Bone resorption and remodeling are characteristic of chronic otitis media with and without cholesteatoma and otosclerosis. The consequences of this remodeling process may be hearing loss, repeated infection, vestibular disturbance, or intracranial complications. Evidence of osteoclastic bone resorption was found in surgical specimens of 11 of 24 cases of cholesteatoma, two of three cases of chronic otitis media, and three of ten cases of otosclerotic stapes; all three spongiotic lesions had osteoclasts. With careful serial sectioning these cells are almost always multinucleate and have the typical appearance of osteoclasts with ruffled borders. Some specimens had evidence of bone erosion in the absence of osteoclasts; this finding represents an inactive phase of the remodeling process. Since the osteoclast plays an important role in the resorption and remodeling of bone in these middle ear diseases, the source, physiology, and local control of these cells are of prime importance in investigating the pathophysiology of these diseases. At the present time, the local control of activation and recruitment of osteoclasts, as well as their chemotactic responses, is poorly understood.
骨吸收和重塑是伴有或不伴有胆脂瘤的慢性中耳炎以及耳硬化症的特征。这种重塑过程的后果可能是听力损失、反复感染、前庭功能障碍或颅内并发症。在24例胆脂瘤手术标本中的11例、3例慢性中耳炎中的2例以及10例耳硬化镫骨病例中的3例发现了破骨细胞性骨吸收的证据；所有3个海绵状病变均有破骨细胞。通过仔细的连续切片，这些细胞几乎总是多核的，并且具有带有皱襞边缘的典型破骨细胞外观。一些标本在没有破骨细胞的情况下有骨侵蚀的证据；这一发现代表了重塑过程的非活动期。由于破骨细胞在这些中耳疾病的骨吸收和重塑中起重要作用，这些细胞的来源、生理学和局部控制在研究这些疾病的病理生理学中至关重要。目前，对破骨细胞激活和募集的局部控制及其趋化反应了解甚少。
