Abstract
Chronic suppurative otitis media (CSOM) is a leading cause of hearing loss and otorrhea, and when associated with cholesteatoma, it can pose a serious threat to patients' lives. This study aims to identify differences in tissue metabolites between patients with CSOM, both with and without cholesteatoma. Metabolomic profiles were measured in tissue samples from 42 surgically treated CSOM patients (35 with cholesteatoma, 7 without cholesteatoma). Significantly altered metabolites associated with CSOM were identified using a non-targeted metabolomics approach and a targeted metabolomics approach. The 42 patients were divided into screening and validation sets. The non-targeted analysis revealed 484 distinct differential metabolites and 32 metabolic pathways that differed between CSOM with and without cholesteatoma in the screening set. Targeted metabolomics confirmed that levels of azobenzene and marimastat in the validation set exhibited trends similar to those observed in the non-targeted analysis. Azobenzene and marimastat were found to be associated with the differences between CSOM with and without cholesteatoma, as well as with bone erosion in the middle ear. This study identified novel potential metabolic pathways and metabolites, providing insights into their possible roles in the inflammatory processes and bone erosion associated with CSOM and cholesteatoma.