Dr, Osman Mamıkoğlu Award

Abstract

Introduction: Cholesteatoma is a mass consisting of  keratinized squamous epithelium and subepithelial connective tissue fragments inside the tympanic or mastoid cavity. Cholesteatoma attacks bone progressively, creates continuous inflammation, and causes significant complications including meningitis. Although many theories have been produced to explain the etiopathogenesis of cholesteatoma, the main pathogenetic components are still unknown. In our study, we observed the immunomodulatory effects of various immune response modifier drugs on cholesteatoma and demonstrated their effects on proliferation in cell culture.

Methods: To observe the pathogenesis of cholesteatoma and to apply the immunomodulatory drugs, cholesteatoma tissue culture models were constituted with HEKa cells and cholesteatoma keratinocytes, which were obtained from three patients who underwent operations for cholesteatoma. Medicines including 5-fluorourasil, imiquimod, cyclosporine, and tacrolimus were applied on both cholesteatoma keratinocytes and HEKa cells. After 48 hours of incubation, IL-1, IL-6, IL-8, IL-10, TNF-α, and Ki67 levels were measured to determine cell viability rates.

Results: In the cholesteatoma control group, IL-6 and TNF-α levels were found higher than in the HEKa control group. All repurposed drugs in the study demonstrated anti-inflammatory, anti-proliferative, and cytotoxic effects on cholesteatoma. Imiquimod and tacrolimus in particular are potential treatment prospects for cholesteatoma due to their strong anti-inflammatory and cytotoxic effects.

Conclusion: Medical therapy options for cholesteatoma are still missing and surgery is not the ultimate solution. We have focused on intercellular inflammatory processes, which play significant roles in the pathogenesis of cholesteatoma in our paper. Inflammation and proliferation of cholesteatoma decreased after all repurposed drug applications in our study. Anti-inflammatory and anti-proliferative effects of tacrolimus and imiquimod was more significant than other drugs in the study. For this reason, tacrolimus and imiquimod should be examined in depth with in vivo studies in terms of efficacy and safety for medical treatment of cholesteatoma.

The ceremony was held on March 17, 2021 at the University of Eskisehir Osmangazi, Department of Otolaryngology, and award was presented by Prof Armagan Incesulu to Dr. Uzun.

Dr. Berat Demir won the 2019 award with his study about BACTERIAL CELLULOSE TUBES AS A NERVE CONDUIT FOR REPAIRING COMPLETE FACIAL NERVE TRANSECTION IN A RAT MODEL 

Purpose: Functionality of the facial nerve is cosmetically important. While many techniques have been investigated, early and effective treatment for traumatic facial nerve paralysis 

remains challenging. Here, we aim to examine bacterial cellulose (BC) as a new tubularization material for improving facial nerve regeneration. 

Methods: Our study was performed on 40 female Sprague Dawley rats. Rats were randomly 

divided into four groups, with 10 rats per group. In all rats, the main trunk of the facial nerve was completely cut 8 mm before the branching point. For repairing the facial nerve, in group 1, 

the nerve was left to recover spontaneously (control group); in group 2, it was repaired by primary suturing (8.0 Ethilon sutures, Ethicon); in group 3, BC tubes alone were used to aid 

nerve repair; and in group 4, both BC tubes and primary sutures (8.0 Ethilon sutures) were used. 

After 10 weeks, the facial nerve regeneration was evaluated by the whisker movement test and electrophysiologically (nerve stimulation threshold and compound muscle action potential). 

Nerve regeneration was assessed by calculating the number of myelinated nerve fibers, and by microscopically evaluating the amount of regeneration and fibrosis. 

Results: No significant difference was observed among the groups in terms of whisker 

movement and electrophysiological parameters (P > 0.05). We found the numbers of regenerating myelinated fibers were significantly increased (P < 0.05) when BC tubes were 

used as a nerve conduit.  

Conclusions: BC can be easily shaped into a hollow tube that guides nerve axons, resulting in 

better nerve regeneration after transection.