Abstract
OBJECTIVES: To explore the expression of periostin in the epithelium of cholesteatoma with different destruction degrees of the ossicular chain and its clinical value in predicting postoperative hearing recovery. METHODS: Retrospective analysis was conducted on the clinical data of 100 patients with middle ear cholesteatoma (the cholesteatoma group) admitted to our hospital. Another 100 patients without middle ear cholesteatoma treated in our hospital during the same period were included in the non-cholesteatoma group. Middle ear cholesteatoma patients were further divided into a normal group, a partial destruction group, and a complete destruction group based on the destruction degree of the ossicular chain (Maresh grading). After the treatment, 75 cases were considered as the effective group and 25 cases as the ineffective group. The expression of tumor necrosis factor-alpha, Interleukin 6, and periostin in the epithelium of middle ear cholesteatoma patients with different destruction degrees of the ossicular chain and different therapeutic effects were compared. The correlation between periostin and inflammatory factors was analyzed using Pearson analysis. The predictive value of tumor necrosis factor-alpha, Interleukin 6, and periostin on treatment effect was valued using the receiver operating characteristic curve. RESULTS: Patients in the cholesteatoma group had a much higher content of tumor necrosis factor-alpha, Interleukin 6, and periostin than those in the non-cholesteatoma group (P < 0.001). The expression of tumor necrosis factor-alpha, Interleukin 6, and periostin was also largely increased with the destruction group of the ossicular chain. Patients in the ineffective group had much higher expression of tumor necrosis factor-alpha, Interleukin 6, and periostin than those in the effective group (P < 0.001). The Pearson correlation analysis results showed that periostin was positively correlated with the content of tumor necrosis factor-alpha and interleukin 6 (P = 0.868, 0.880, P < 0.001). The areas under the curve of individual or joint tumor necrosis factor-alpha, Interleukin 6, and periostin were 0.627, 0.793, 0.822, and 0.892, respectively. CONCLUSIONS: The expressions of periostin, Interleukin 6, and tumor necrosis factor-alpha were markedly increased in the epithelium of middle ear cholesteatoma patients, which were gradually increased with the aggravation of the ossicular chain destruction. Periostin, Interleukin 6, and tumor necrosis factor-alpha could be used as important indicators to predict postoperative hearing recovery.