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Objectives: Recurrences are still a challenge despite
appropriate techniques in cholesteatoma surgery. This
study was designed to evaluate the level of Ki-67 expression
in recurrent cases of cholesteatoma.
Patients and Methods: The study included 32 patients
(18 males, 14 females; mean age 34 years; range 12 to 63
years) who underwent surgery for otitis media. Of these,
19 patients had cholesteatoma, and eight patients had
recurrent cholesteatoma. Five patients who underwent
tympanoplasty for chronic otitis media comprised the control
group. All the patients with cholesteatoma underwent
radical mastoidectomy. At surgery, tissue samples of
cholesteatoma were taken and prepared for immunohistochemical
staining. In controls, retroauricular skin samples
were used. The two patient groups with cholesteatoma
were compared with respect to Ki-67 expression.
Results: Increased cellular proliferation was detected
in both groups of cholesteatoma. No significant difference
was found between two cholesteatoma groups
with respect to Ki-67 staining (p>0.05). Compared to
the controls, patients with cholesteatoma and those
with recurrent cholesteatoma had significantly higher
levels of Ki-67 staining (p<0.05 and p<0.01, respectively).
Conclusion: Our results suggest that, despite a higher
degree of proliferation in recurrent cholesteatoma cases,
treatment failures may be mainly associated with the surgical
technique, accompanying infections, and the type of
cholesteatoma.